Under dosing of AEDs and aggressive weaning of anesthetic agents may result in higher morbidity and mortality. This retrospective review demonstrates how guidelines and recommendations for SE are not consistently followed. Seizure recurrence rates were: 8/32 (25%) 72 hours. Status epilepticus (SE) is a heterogenous electro- clinical syndrome with diverse causes, inconsistent and dynamic clinical manifestations, and variable clinical course. Anesthetic agents were weaned as follows: 72 hours 11/71 (15%). Medications were under dosed as follows: lorazepam 0.05 mg/kg (N=51), midazolam 0.07 mg/kg (N=14), fosphenytoin 17.9 mg/kg (N=47), levetiracetam 21.7 mg/kg (N=42), valproate sodium 16.7 mg/kg (N=12), phenobarbital 4.1 mg/kg (N=4), lacosamide 215 mg (N=13), and topiramate 333 mg (N=3). 2 These underlying brain problems may include trauma, infections, or strokes, among others. 1 Status epilepticus may occur in those with a history of epilepsy as well as those with an underlying problem of the brain. Five patients had anoxic brain injury and were excluded from the anesthetic weaning analysis. Status epilepticus is a life-threatening medical emergency, particularly if treatment is delayed. Seventy-six patients were identified on anesthetic agents. Status epilepticus is said to occur when a seizure is prolonged, where seizures occur in close succession or the person doesnt recover between seizures. Patients with anoxic brain injury were excluded when reviewing anesthetic wean times. Once intubation and mechanical ventilation are established, the outcome is primarily related to the underlying brain disease and the ability to control seizures. This is a medical emergency that may lead to permanent brain. All patients with SE on anesthetic agents were included when analyzing AED dosing. Status epilepticus is a clinical expression of potentially severe brain disease and may threaten life through impairment of airway control and respiratory function. A seizure that lasts at least 30 minutes is called status epilepticus, or a prolonged seizure. Our aim was to determine the frequency with which guidelines were being followed during routine clinical care.Ī retrospective chart review was completed for patients with a diagnosis of SE within the last 10 years. ![]() There are also recommendations for appropriate weaning off anesthetic agents in SE. The American Epilepsy Society (AES) has established guidelines regarding proper dosing of antiepileptic drugs (AEDs). Status epilepticus (SE) is associated with high morbidity and mortality.
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