Guía clínica. Estado epiléptico en niños y adultos

Abstract

A generalized epileptic seizure lasting five or more minutes, or the presence of two or more seizures without recovery of consciousness in thirty minutes, or a focal seizure that persists for more than 10 min or with altered consciousness for 60 min or more duration is called status epilepticus. It can be classified into generalized and focal, motor and non-motor. Its etiology may or may not be recognized. The electroencephalographic pattern shows focal or generalized persistent epileptic activity. It is a dangerous situation, which requires algorithmic management since it is detected, in the emergency Room and if required in the intensive therapy unit. In-hospital management would include the initial ABCDE , hypertonic glucose solution and thiamin if hypoglycemia is detected. Lorazepam (midazolam or diazepam) to juggle seizures, followed by phenytoin, valproate or levetiracetam in impregnation and sustain. If the status epilepticus persists for more than an hour, the patient will be referred to an ICU