Treatment of status epilepticus: use of the antiepileptic drugs and outcomes in hospitals of level 4 in Colombia
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Keywords

Anticonvulsants/therapeutic use
Status epilepticus/diagnosis/mortality
reatment outcome (MeSH)

Abstract

Introduction: Status Epilepticus (SE) is a neurological emergency associated with high morbidity and mortality; treatment should be based on international guidelines.

Objective: To describe the frequency of application of anticonvulsants used for the treatment of SE in hospitals of level 4 in Colombia.

Materials and methods: A series of patients over 14.5 years old, with the diagnosis of SE registered by the neurologist, treated between August 2013 and July 2014.

Results: A series of 84 cases, with a median patient age of 52,5 years (IQR 27-71,5); 64.3% of patients (n=54) have featured the previous history of epilepsy. The most frequent type of epileptic status was tonic and clonic among 57,1% (n=48), and the main cause has been uncontrolled epilepsy among 53,6% (n=46). The first-line treatment of the patients was combinations of benzodiazepine with other anticonvulsants, among which the most applied were phenytoin and valproic acid. All anticonvulsants were administered intravenously. 32 patients (38,1%) have required management in intensive care unit. The outcomes were death in 17 cases (20,2%) and 6 patients (7,2%) had neurological sequels without death.

Conclusion: The classical antiepileptic drugs, among which are phenytoin and valproic acid, remain the election in the first-line treatment of SE. The combination of valproic acid and levetiracetam may be effective in refractory SE. Alternative therapies of SE were not observed in hospitals of the study.

https://doi.org/10.22379/2422402269

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