Table 2.
Characteristics of articles included in the guideline
| References | Intervention | Study design total population | L.E | Result and conclusion |
|---|---|---|---|---|
| Wei wu. et al.2016 | Lorazepam or diazepam for treatments of convulsive status epilepticus. | Meta-analysis Six RCT. Total Population=970 DZP=499 LZP=471. |
1a | No significance difference between the two treatment groups regarding • Seizure control [OR], 0.73, 95% CI 0.35–1.55; I 2=0.0%, P=0.157). • cessation of seizure within 20 minutes (OR, 0.73, 95% CI 0.46–1.15; I 2=0.0%, P=0.175). |
| Brigo. et al. 7 | Is intravenous lorazepam really more effective and safe than intravenous Diazepam as first-line treatment for convulsive status epilepticus? |
A systematic review with meta-analysis of Five RCT. Total population=656 LZP=320 and DZP=336 patients allocated. |
1a | No statistically significant differences were found between IV LZP and IV DZP • Clinical seizure cessation (RR 1.09; 95% CI 1.00–1.20), • continuation of SE requiring a different drug (RR 0.76; 95% CI 0.57–1.02), • Seizure cessation after a single dose of medication (RR 0.96; 95% CI 0.85–1.08), • Need for ventilator support (RR 0.93; 95% CI 0.61–1.43) and clinically relevant hypotension. |
| Amir. et al. 16 | Sodium valproate compared to phenytoin in treatment of status epilepticus. |
RCT Total patient=110 Phenytoin group=55 Sodium valproate=55. |
1a | • Seizure control 43 (78.18%) with VPA and 39 (70.90%) with PHT within 7 days of drug Administration (P=0.428). • mortality rate was similar in both groups (12.73 vs. 12.73%; P=0.612). • There was no significant difference in adverse effects between two groups. |
| Tiamkao. et al. 18 | The efficacy of intravenous sodium valproate and phenytoin as the first-line treatment in status epilepticus: |
Comparison study. Total patient=54 Phenytoin group=37 Sodium valproate=17 |
1b | There were no significant differences between the PHT and VPA • clinically-controlled seizures, time to seizure control, • Duration of hospitalization and death. • No serious cardiovascular event such as hypotension occurred in either group. Conclusion. IV VPA is noninferior to IV PHT as the first-line treatment in SE With no significant cardiovascular compromises. |
| Rosati. et al. 9 | Ketamine for refractory status epilepticus. | Systematic review. Total population=219. |
2b | Ketamine was effective with an efficacy rate of dropping seizure from 64 to 32% in 42 patients with RSE lasting 3 days with mean duration of 26 days. Conclusion: The Study has methodological limitation and feature clinical trials will be needed to confirm the efficacy of early administration of ketamine for status epilepticus. |
| Alkhachroum.et.al. 22 | Ketamine to treat super-refractory status epilepticus. | Retrospective cohort study. Total population=261. |
2b | • Seizure burden decreased by 50% within 24 h. Of starting ketamine in 55 (81%) patients with complete seizure cessation in 43 (63%) of patients. • Ketamine was associated with stable mean arterial pressure (OR 1.39, 95% CI 1.38–1.40) and decrease vasopressor requirements. Conclusion: Ketamine treatment was associated with a decrease in seizure burden in patient with SRSE. |
| Gaspard.et al. 20 | Intravenous ketamine for refractory status epilepticus. | Multicenter retrospective study. Total population=60. |
2b | • Permanent control of refractory status epilepticus was 57% out of 60 patient who were treated with ketamine. |
| Zhang.et al. 8 | Systematic review and meta-analysis of propofol versus Thiopentone for controlling refractory status epilepticus. |
Systematic review and meta-analysis. Seven RCT. |
1a | Meta-analysis revealed that • The Disease control rate of propofol was higher than that of barbiturates (P<0.001) and The Case fatality rate (P=0.382). • Propofol also shortened the average tracheal placement time (P<0.001) of RSE. • reduced the ATIPT (P<0.001) of patients with RSE more extensively than did barbiturates and • Did not increase the incidence of hypotension (P=0.737). Conclusions: In comparison with barbiturates, propofol can control RSE and shorten ATIPT in a more efficient and timely manner and the drug do not increase the incidence of hypotension and Case fatality. |
| Prapbhakar.et al. | Propofol versus thiopental sodium for the treatment of refractory status epilepticus. | Cochrane Database of Systematic Reviews. | 1a | • The number of day of mechanical ventilator was greater in thiopental sodium group when compared with propofol group (median range) 17 days (5–70 days) with thiopental sodium and four days (2–28 days) with propofol) group. |
| Dastasheib et al. | The effect of Mozart music on interectal activity in epileptic patient. | Systemic review and metha-anlysis with 8 RCT and 4 case report. | 5 | • The therapeutic effect of music is effective since it is noninvasive and inexpensive adjuvant antiepileptic therapy with less side effect. |