Which is preferred in status epilepticus?

Lorazepam. Lorazepam has emerged as the preferred benzodiazepine for acute management of status epilepticus.

What is the meaning of refractory seizures?

These seizures may last a few seconds or a few minutes. Some people with epilepsy will have, or will one day develop, refractory epilepsy. This means that medicines don’t work well, or at all, to control the seizures. If you have refractory epilepsy, the type of seizures you have may affect your treatment.

What is the difference between refractory and intractable epilepsy?

Intractable epilepsy is when seizures can’t be completely controlled by medicines. (Intractable means “not easily managed or relieved.”) It’s also called refractory, uncontrolled, or drug-resistant epilepsy.

Which drug is effective against refractory epilepsy?

Many drugs can treat epilepsy, including: Brivaracetam (Briviact) Cannabidiol (Epidiolex) Carbamazepine (Carbatrol, Tegretol)

When is status epilepticus defined as refractory?

Refractory status epilepticus (RSE) can be defined as status epilepticus that continues despite treatment with benzodiazepines and one antiepileptic drug. RSE should be treated promptly to prevent morbidity and mortality; however, scarce evidence is available to support the choice of specific treatments.

How is refractory status epilepticus treated?

Management of refractory status epilepticus involves treatment of an underlying etiology in addition to intravenous anesthetics and antiepileptic drugs. Alternative treatment options including diet therapies, electroconvulsive therapy, and surgical resection in case of a focal lesion should be considered.

Why is refractory epilepsy a problem?

Refractory epilepsy can have a big effect on your life. People with refractory epilepsy may have trouble at work or school. They may worry a lot about when their next seizure will come. They may also have injuries that result from their seizures.

Is refractory epilepsy serious?

Most epilepsy specialists agree that refractory epilepsy is epilepsy for which seizures are frequent and severe enough, or the required therapy for them troublesome enough, to seriously interfere with quality of life.

How do you control refractory epilepsy?

Managing refractory epilepsy A special diet called a ketogenic diet may help control your seizures. This type of diet is high in fats and low in carbohydrates. If you follow this diet, you will need to work closely with your doctor and take supplements of certain nutrients as needed.

What causes refractory status epilepticus?

Most of the causes of RSE can be identified within 24-72 hours of presentation, as it is commonly due to an obvious acute brain injury (stroke, trauma, etc.) or serious acute medical illness. RSE may also occur in people with epilepsy (also known as a seizure disorder).

What is refractive status epilepticus?

Refractory status epilepticus is defined as persistent seizures despite appropriate use of two intravenous medications, one of which is a benzodiazepine. It can be seen in up to 40% of cases of status epilepticus with an acute symptomatic etiology as the most likely cause.

When is status epilepticus considered refractory?

What percentage of epilepsy is refractory?

This condition is also referred to as intractable, medically refractory, or pharmacoresistant epilepsy. As many as 20 to 40 percent of patients with epilepsy (roughly 400,000 people living in the United States) are likely to have refractory epilepsy.

Is favorable outcome possible after prolonged refractory status epilepticus?

In many series, prolonged, refractory SE has a mortality of 30% to 50%, and several studies indicate that most survivors have a substantial decline in functional status. Nevertheless, several reports demonstrate that good functional outcome is possible even after several days of SE and coma induction.

What is prolonged refractory status epilepticus?

Prolonged refractory status epilepticus was defined as SE in which treatment with anesthetic agents was required for 7 or more days to suppress SE. Duration of PRSE was calculated from the day when SE was first identified to the day when anesthetic drugs were successfully discontinued without recurrence of SE.