| Title |
Pharmacotherapy for Status Epilepticus
|
|---|---|
| Published in |
Drugs, August 2015
|
| DOI | 10.1007/s40265-015-0454-2 |
| Pubmed ID | |
| Authors |
Eugen Trinka, Julia Höfler, Markus Leitinger, Francesco Brigo |
| Abstract |
Status epilepticus (SE) represents the most severe form of epilepsy. It is one of the most common neurologic emergencies, with an incidence of up to 61 per 100,000 per year and an estimated mortality of 20 %. Clinically, tonic-clonic convulsive SE is divided into four subsequent stages: early, established, refractory, and super-refractory. Pharmacotherapy of status epilepticus, especially of its later stages, represents an "evidence-free zone," due to a lack of high-quality, controlled trials to inform clinical decisions. This comprehensive narrative review focuses on the pharmacotherapy of SE, presented according to the four-staged approach outlined above, and providing pharmacological properties and efficacy/safety data for each antiepileptic drug according to the strength of scientific evidence from the available literature. Data sources included MEDLINE and back-tracking of references in pertinent studies. Intravenous lorazepam or intramuscular midazolam effectively control early SE in approximately 63-73 % of patients. Despite a suboptimal safety profile, intravenous phenytoin or phenobarbital are widely used treatments for established SE; alternatives include valproate, levetiracetam, and lacosamide. Anesthetics are widely used in refractory and super-refractory SE, despite the current lack of trials in this field. Data on alternative treatments in the later stages are limited. Valproate and levetiracetam represent safe and effective alternatives to phenobarbital and phenytoin for treatment of established SE persisting despite first-line treatment with benzodiazepines. To date there are no class I data to support recommendations for most antiepileptic drugs for established, refractory, and super-refractory SE. Limiting the methodologic heterogeneity across studies is required and high-class randomized, controlled trials to inform clinicians about the best treatment in established and refractory status are needed. |
X Demographics
The data shown below were collected from the profiles of 5 X users who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Spain | 2 | 40% |
| Unknown | 3 | 60% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 4 | 80% |
| Practitioners (doctors, other healthcare professionals) | 1 | 20% |
Mendeley readers
The data shown below were compiled from readership statistics for 311 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| United States | 2 | <1% |
| Italy | 1 | <1% |
| Brazil | 1 | <1% |
| Unknown | 307 | 99% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Researcher | 39 | 13% |
| Other | 35 | 11% |
| Student > Bachelor | 35 | 11% |
| Student > Postgraduate | 31 | 10% |
| Student > Master | 31 | 10% |
| Other | 71 | 23% |
| Unknown | 69 | 22% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 124 | 40% |
| Neuroscience | 34 | 11% |
| Pharmacology, Toxicology and Pharmaceutical Science | 28 | 9% |
| Nursing and Health Professions | 16 | 5% |
| Agricultural and Biological Sciences | 11 | 4% |
| Other | 23 | 7% |
| Unknown | 75 | 24% |
Attention Score in Context
This research output has an Altmetric Attention Score of 10. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 08 May 2017.
All research outputs
#3,500,079
of 23,978,545 outputs
Outputs from Drugs
#468
of 3,364 outputs
Outputs of similar age
#46,188
of 271,040 outputs
Outputs of similar age from Drugs
#6
of 37 outputs
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So far Altmetric has tracked 3,364 research outputs from this source. They typically receive a little more attention than average, with a mean Attention Score of 7.4. This one has done well, scoring higher than 86% of its peers.
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We're also able to compare this research output to 37 others from the same source and published within six weeks on either side of this one. This one has done well, scoring higher than 86% of its contemporaries.