Journal of Epilepsy and Clinical Neurophysiology
On-line version ISSN 1980-5365
FABIO, Agertt; ANTONIUK, Sérgio Antonio; BRUCK, Isac and SANTOS, Lúcia Coutinho dos. Treatment status epilepticus in children: revision and proposal of protocol. J. epilepsy clin. neurophysiol. [online]. 2005, vol.11, n.4, pp. 183-188. ISSN 1980-5365. http://dx.doi.org/10.1590/S1676-26492005000400006.
INTRODUCTION: The definition of Status Epilepticus (SE) understands drawn out seizures or recurrent seizures without recovery of consciousness per 30 minutes. Beyond frequent, it has high mortality and morbidity. There have some proposals of treatment, without uniformity. OBJECTIVE: To review the treatment options for SE and propose a protocol for treating SE. METHODOLOGY: Revision in the Medline, and proposal of protocol. RESULTS: The initial proceeding in SE is the establishment of life support and use of antiepileptic medication. The benzodiazepines are medications of first line. Intravenous phenytoin is used concomitant to the benzodiazepines. This is efficient in stopping seizures, however with delay of action. Phenobarbital is the third most used and efficient drug; however the complications may indicate intensive cares. The SE that does not cease is considered refractory, demands use of midazolam in continuous infusion or anesthesia, while propofol have been less used. Combining this review with the experience of our service, we proposed a protocol for treating SE. CONCLUSION: There are controversies in the protocols for treatment of SE, and further studies involving pediatrics patients could help to clarify this issue. The presented protocol aims at a treatment with minimum of morbidity.
Keywords : treatment status epilepticus; pediatric; antiepileptic drugs.