Is Favorable Outcome Possible After Prolonged Refractory Status Epilepticus?

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State: Public
Version: Author's accepted manuscript
Serval ID
serval:BIB_45DC74A7ACB6
Type
Article: article from journal or magazin.
Publication sub-type
Review (review): journal as complete as possible of one specific subject, written based on exhaustive analyses from published work.
Collection
Publications
Institution
Title
Is Favorable Outcome Possible After Prolonged Refractory Status Epilepticus?
Journal
Journal of Clinical Neurophysiology : Official Publication of the American Electroencephalographic Society
Author(s)
Alvarez V., Drislane F.W.
ISSN
1537-1603 (Electronic)
ISSN-L
0736-0258
Publication state
Published
Issued date
2016
Peer-reviewed
Oui
Volume
33
Number
1
Pages
32-41
Language
english
Notes
Publication types: Journal Article ; Meta-Analysis ; Review
Publication Status: ppublish
Abstract
When status epilepticus (SE) remains refractory to appropriate therapy, it is associated with high mortality and with substantial morbidity in survivors. Many outcome predictors such as age, seizure type, level of consciousness before treatment, and mostly, etiology, are well-established. A longer duration of SE is often associated with worse outcome, but duration may lose its prognostic value after several hours. Several terms and definitions have been used to describe prolonged, refractory SE, including "malignant SE," "prolonged" SE, and more recently, "super refractory" SE, defined as "SE that has continued or recurred despite 24 hours of general anesthesia (or coma-inducing anticonvulsants)." There are few data available regarding the outcome of prolonged refractory SE, and even fewer for SE remaining refractory to anesthetic drugs. This article reviews reports of outcome after prolonged, refractory, and "super refractory" SE. Most information detailing the clinical outcome of patients surviving these severe illnesses, in which seizures can persist for days or weeks (and especially those concerning "super-refractory" SE) come from case reports and retrospective cohort studies. In many series, prolonged, refractory SE has a mortality of 30% to 50%, and several studies indicate that most survivors have a substantial decline in functional status. Nevertheless, several reports demonstrate that good functional outcome is possible even after several days of SE and coma induction. Treatment of refractory SE should not be withdrawn from younger patients without structural brain damage at presentation solely because of the duration of SE.
Keywords
Age Distribution, Anesthetics/therapeutic use, Anticonvulsants/therapeutic use, Chronic Disease, Evidence-Based Medicine, Humans, Prevalence, Prognosis, Risk Factors, Sex Distribution, Status Epilepticus/mortality, Status Epilepticus/prevention & control, Survival Rate, Treatment Failure, Treatment Outcome
Pubmed
Web of science
Create date
16/02/2016 17:17
Last modification date
20/08/2019 13:50
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