Talk:Status epilepticus

We've lots of references
We've got almost 20 references on lidocaine, many of which are in Japanese. Is there any way for making this tighter? I also don't think animal studies are immensely helpful here. JFW | T@lk  13:04, 15 July 2005 (UTC)


 * The abstracts themselves aren't in Japanese, and there's only one reference I can find to a lidocaine-induced seizure in humans.


 * Maybe I could lose a few of the rat studies.

If there's only one reference about lidocaine-induced seizures it may not be very common and therefore may not even need to be mentioned. I think we need more outline articles from a clinical point-of-view. JFW | T@lk  16:21, 15 July 2005 (UTC)

Actually, I was able to find two more cases, which I didn't include because just saying that it's a proconvulsant at doses above 3 mg/kg was enough. Also, the 5-8 mg/kg dose used in epidurals has been known to cause seizures when the needle bumps into a vein and it becomes an intravenous infusion instead.

By doing this, I was able to get rid of all the animal studies.

Well, all of the ones on lidocaine.Rmky87 23:53, 30 July 2005 (UTC)

Missing drug name?
Is there another drug name missing from this paragraph? (i.e. The pharmacological effects of what were longer lasting than diazepam?) Introspensive 20:51, 28 February 2006 (UTC)

"Shortly after it was introduced in 1963, diazepam became the first choice for SE. Even though other benzodiazepines such as clonazepam were useful, diazepam was relied upon almost exclusively. This began to change in 1975 with a preliminary study conducted by Waltregny and Dargent, who found that its pharmacological effects were longer lasting than those of an equal dose of diazepam.[3] This meant it did not have to be repeatedly injected like diazepam,[4] the effects of which would wear off 5-15 minutes later in spite of its 30-hour half-life."

Neuronal injury in 5 minutes
Could someone provide a reference, or possibly update the statement in the intro of "There is some evidence that five minutes is sufficient to damage neurons and that seizures are unlikely to self-terminate by that time.". I can't seem to find anywhere that backs that claim up; some places like UptoDate suggest 30-60mins, and another website (I've closed it now, can't remember where it was) said there's no evidence less than 20 minutes of continuous seizure activity causes permanent damage. I'm certainly not qualified to do this myself. — Preceding unsigned comment added by 203.100.212.146 (talk) 01:07, 17 September 2014 (UTC)

Some further structuring of the article
I think it would be helpful to extend the article to currently used typifying of SE's accepted internationally by neurology/epileptology organizations (i.e., instead of dichotomisation only to convulsive and nonconvulsive SE's, (1)generalised tonic-clonic seizure status, (2)convulsive and nonconvulsive simple- or complex-focal seizures status, (3)absence status (generalised nonconvulsive seizure status) and (4)"subtle status epilepticus").

I think, that the overview of medicamentous treatment options should be "staged" (i.e., 1) BZD, if not effective, than 2) PHE or VAL, if not effective, than 3) BARBs, if not effective, than 4) general anesthesia ± muscle (curaremimetic) relaxation.

In the first-line treatment options, use of lorazepam IV should be stressed, as some reliable sources suggests that the anticonvulsive effect of IV lorazepam lasts for substantialy longer periods than that of IV diazepam and is more versatile than that of IV clonazepam. (thus, http://dgn.dgni.de/132.0.html suggests IV lorazepam to be the first-line-option of the step 1) of the "medication ladder", followed by IV clonazepam and at last, by IV diazepam)

Also, in my opinion, the IV administered valproate (sodium valproate inj. sol., parenteral equivalent to valproate/divalproex), should be added as a possible option in step 2) of the "medication ladder" (i.e. if the SE is BZD-refractory), along with phenytoin. German Neurologic Society does so.--Spiperon 20:41, 15 October 2006 (UTC)

Ref style
I'm updating this article's reference style to Cite.php; the current reference section is unmanageably long, and the new style is much easier to use. If anyone has any objections, please feel free to revert. Fvasconcellos (t·c) 19:38, 7 October 2007 (UTC)

Update/animal models
I've just read this and have following comments.

The treatment section can be streamlined by putting into a first section to "Standard Therapies" referring to the Vet Admin prospective study on status epilepticus Treiman et al NEJM 1998 and numerous subsequent review articles on the recommended protocol (Lowenstein et al, NEJM 1998) of staged lorazepam, phenytoin, .... and then to "Other therapies for refractory status epilepticus" to account for the numerous other options, some of which are mentioned in the current article.

A brief section on pathophysiology could mention the critical role of time in SE as demonstrated by Meldrum et al (Arch Neurol 1973)

Karmattol (talk) 20:17, 28 August 2008 (UTC)

Status_epilepticus
This sounds very much like original research. In addition, in my experience it is not particularly "notable" - there are many episodes like this. Should it be retained? Scray (talk) 10:39, 4 September 2008 (UTC)


 * Someone else did the deletion, but did not justify the deletion to the satisfaction of a third person who thought that was censorship (and apparently didn't see this section on the talk page). I have deleted the passage, because: the passage sounds like a personal report (i.e. original research smacking of conflict of interest), it lacks neutral point of view and reliable sources.  Anyone feel this is inappropriate?  --Scray (talk) 07:22, 12 September 2008 (UTC)

Issue with ref (15) reference
I have been admininistered Propofol during neuorsurgery following an apoplelptic pituitary tumor with an in-situ CSF leak, resulting in seizures, and I can tell you with great authority that I am most certainly not dead. — Preceding unsigned comment added by Calitrappedindc (talk • contribs) 03:23, 19 September 2012 (UTC)

My brother was adminstered Propofol twice for monoclonic status epilepticus and it did not kill him. It worked very well and likely saved his life. I recommend it as a possible last option. He is dead though, but due to a hospital error six months later: administering a benzo while placing him in a three point restraint. He died of aspiration. I think the wording needs to be changed here. — Preceding unsigned comment added by Steppenwolfsayshi (talk • contribs) 00:15, 25 January 2014 (UTC)

Frequency
Ref says "SE is one of the most common neurologic emergency, with an overall annual incidence of 10–41 per 100,000" Doc James  (talk · contribs · email) 02:03, 28 February 2015 (UTC)

Status
The current definition is more than 5 minutes. Ref says "E is defined as convulsions lasting for 5 or more minutes or recurrent episodes of convulsions in a 5-minute interval without return to preconvulsive neurologic baseline." The older definition was 30 minutes. Doc James (talk · contribs · email) 06:05, 23 April 2015 (UTC)
 * This definition is now, again, the thirty minute one according to the 2016 ILAE Glauser et al guidelines, motion to change this and cite the latest ILAE guidelines? Aglo123 (talk) 16:16, 20 October 2017 (UTC)
 * Apologies; AES, not ILAE, guidelines Aglo123 (talk) 16:17, 20 October 2017 (UTC)
 * Apologies, again, I realize my mistake. The ILAE definition has the convulsive SE type as lasting longer than 5 minu

s, and the other was 10 minutes...Maybe that should be differentiated in the intro paragraph?e — Preceding unsigned comment added by Aglo123 (talk • contribs) 16:28, 20 October 2017 (UTC)

Review
In Lancet Neurology 10.1016/S1474-4422(15)00042-3 JFW &#124; T@lk  14:48, 20 May 2015 (UTC)

Ketogenic diet being considered
Could mention Ketogenic Diet May Help in Tough-to-Treat Epilespy in Research ? - Rod57 (talk) 12:11, 6 December 2017 (UTC)

Only single acute attacks, or increased risk of future attacks
Intro makes it sound like a person only has one acute occurrence, yet the suggestion for ketogenic diets implies they are a preventive measure to reduce future occurrence. How often do they tend to happen ? Once you've had one, what is the risk of another within a year (compared with not having had it) ? - Rod57 (talk) 12:22, 6 December 2017 (UTC)

Hi Wikipedian
welcome all, I am a undergraduate student from Uskudar university, Istanbul/Turkiye, I am proceeding my summer course 2023: Special Topics in Neuroscience, in which we are required to edit Wikipedia articles related to Neuroscience, editing status epilepticus is my assignment. You feel free to give feedbacks. SM2108 (talk) 13:52, 22 August 2023 (UTC)

Section unclear
I found the "Prevalence" section to be confusing. Splitting at least one of the sentences into two will help, but it may need to be completely restructured. RowanDreamer (talk) 04:33, 6 September 2023 (UTC)