Pharmacological management of seizures and status epilepticus in critically ill patients

J Pharm Pract. 2010 Oct;23(5):441-54. doi: 10.1177/0897190010372321. Epub 2010 Aug 5.

Abstract

Seizures are serious complications seen in critically ill patients and can lead to significant morbidity and mortality if the cause is not identified and treated quickly. Uncontrolled seizures can lead to status epilepticus (SE), which is considered a medical emergency. The first-line treatment of seizures is an intravenous (IV) benzodiazepine followed by anticonvulsant therapy. Refractory SE can evolve into a nonconvulsive state requiring IV anesthetics or induction of pharmacological coma. To prevent seizures and further complications in critically ill patients with acute neurological disease or injury, short-term seizure prophylaxis should be considered in certain patients.

Publication types

  • Review

MeSH terms

  • Animals
  • Anticonvulsants / therapeutic use
  • Benzodiazepines / therapeutic use
  • Critical Illness / therapy*
  • Disease Management
  • Humans
  • Hypnotics and Sedatives / therapeutic use
  • Intensive Care Units
  • Seizures / drug therapy*
  • Seizures / physiopathology
  • Status Epilepticus / drug therapy*
  • Status Epilepticus / physiopathology

Substances

  • Anticonvulsants
  • Hypnotics and Sedatives
  • Benzodiazepines