An update in the initial management of paediatric status epilepticus
| Autor: | Ben Lawton, Tessa Davis, Andrew Tagg, Henry Goldstein |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
Phenytoin
medicine.medical_specialty Lacosamide medicine.drug_class Point-of-Care Systems Clinical Decision-Making Status epilepticus law.invention 03 medical and health sciences Status Epilepticus 0302 clinical medicine Randomized controlled trial law medicine Humans heterocyclic compounds 030212 general & internal medicine Child Intensive care medicine Emergency Treatment Benzodiazepine Convulsive status epilepticus business.industry nervous system diseases Pediatrics Perinatology and Child Health Midazolam Anticonvulsants Levetiracetam medicine.symptom business Algorithms 030217 neurology & neurosurgery medicine.drug |
| Zdroj: | Current Opinion in Pediatrics. 30:359-363 |
| ISSN: | 1040-8703 |
| DOI: | 10.1097/mop.0000000000000616 |
| Popis: | Over the last 2 years, algorithms for the optimal management of status epilepticus have changed, as the medical community has recognized the need to terminate seizures in status in a timely manner. Recent research has evaluated the different choices of benzodiazepine and has given consideration to second-line treatment options. There has been a move to examine alternatives to phenytoin (such as levetiracetam and lacosamide) as second-line agents. Valproate should be used cautiously in view of the potential side effects. Three ongoing trials [Established Staus Epilepticus Treatment Trial (ESETT), Convulsive Status Epilepticus Paediatric Trial (ConSEPT), and emergency treatment with levetiracetam or phenytoin in status epilepticus in children (EcLiPSE)] are comparing the efficacy of levetiracetam and phenytoin. Benzodiazepines remain the first-line agent of choice, although there is ongoing discussion about the mode of administration and the best drug to choose. The results of ESETT, ConSEPT, and EcLiPSE will affect our future management of status, as we give consideration to levetiracetam as an alternative to phenytoin. Other medications such as lacosamide may emerge in future algorithms too. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|