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. 2000 Nov;83(5):415–419. doi: 10.1136/adc.83.5.415

The treatment of convulsive status epilepticus in children

S The 1, M o Party 1, R Appleton 1, I Choonara 1, T Martland 1, B Phillips 1, R Scott 1, W Whitehouse 1
PMCID: PMC1718534  PMID: 11040151

Abstract

There is currently little agreement between hospital protocols when treating convulsive status epilepticus in children, and a working party has been set up to produce a national evidence based guideline for treating this condition. This four step guideline is presented in this paper. Its effectiveness will be highlighted and its use audited in a number of centres.



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Selected References

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  1. Appleton R., Sweeney A., Choonara I., Robson J., Molyneux E. Lorazepam versus diazepam in the acute treatment of epileptic seizures and status epilepticus. Dev Med Child Neurol. 1995 Aug;37(8):682–688. doi: 10.1111/j.1469-8749.1995.tb15014.x. [DOI] [PubMed] [Google Scholar]
  2. Baxter P. Epidemiology of pyridoxine dependent and pyridoxine responsive seizures in the UK. Arch Dis Child. 1999 Nov;81(5):431–433. doi: 10.1136/adc.81.5.431. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Boucher B. A., Feler C. A., Dean J. C., Michie D. D., Tipton B. K., Smith K. R., Jr, Kramer R. E., Young B., Parks B. R., Jr, Kugler A. R. The safety, tolerability, and pharmacokinetics of fosphenytoin after intramuscular and intravenous administration in neurosurgery patients. Pharmacotherapy. 1996 Jul-Aug;16(4):638–645. [PubMed] [Google Scholar]
  4. Browne T. R. Fosphenytoin (Cerebyx). Clin Neuropharmacol. 1997 Feb;20(1):1–12. doi: 10.1097/00002826-199702000-00001. [DOI] [PubMed] [Google Scholar]
  5. Chattopadhyay A., Morris B., Blackburn L., Wassmer E., Whitehouse W. Buccal midazolam and rectal diazepam for epilepsy. Lancet. 1999 May 22;353(9166):1798–1798. doi: 10.1016/S0140-6736(05)75898-0. [DOI] [PubMed] [Google Scholar]
  6. Curless R. G., Holzman B. H., Ramsay R. E. Paraldehyde therapy in childhood status epilepticus. Arch Neurol. 1983 Aug;40(8):477–480. doi: 10.1001/archneur.1983.04210070017006. [DOI] [PubMed] [Google Scholar]
  7. DeLorenzo R. J., Pellock J. M., Towne A. R., Boggs J. G. Epidemiology of status epilepticus. J Clin Neurophysiol. 1995 Jul;12(4):316–325. [PubMed] [Google Scholar]
  8. Garr R. E., Appleton R. E., Robson W. J., Molyneux E. M. Children presenting with convulsions (including status epilepticus) to a paediatric accident and emergency department: an audit of a treatment protocol. Dev Med Child Neurol. 1999 Jan;41(1):44–47. doi: 10.1017/s0012162299000080. [DOI] [PubMed] [Google Scholar]
  9. Grech V., Mizzi J., Mangion M., Vella C. Visceral leishmaniasis in Malta--an 18 year paediatric, population based study. Arch Dis Child. 2000 May;82(5):381–385. doi: 10.1136/adc.82.5.381. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Hoppu K., Santavuori P. Diazepam rectal solution for home treatment of acute seizures in children. Acta Paediatr Scand. 1981;70(3):369–372. doi: 10.1111/j.1651-2227.1981.tb16565.x. [DOI] [PubMed] [Google Scholar]
  11. Knudsen F. U. Rectal administration of diazepam in solution in the acute treatment of convulsions in infants and children. Arch Dis Child. 1979 Nov;54(11):855–857. doi: 10.1136/adc.54.11.855. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Kofke W. A., Young R. S., Davis P., Woelfel S. K., Gray L., Johnson D., Gelb A., Meeke R., Warner D. S., Pearson K. S. Isoflurane for refractory status epilepticus: a clinical series. Anesthesiology. 1989 Nov;71(5):653–659. doi: 10.1097/00000542-198911000-00005. [DOI] [PubMed] [Google Scholar]
  13. Koul R. L., Raj Aithala G., Chacko A., Joshi R., Seif Elbualy M. Continuous midazolam infusion as treatment of status epilepticus. Arch Dis Child. 1997 May;76(5):445–448. doi: 10.1136/adc.76.5.445. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Leppik I. E., Derivan A. T., Homan R. W., Walker J., Ramsay R. E., Patrick B. Double-blind study of lorazepam and diazepam in status epilepticus. JAMA. 1983 Mar 18;249(11):1452–1454. [PubMed] [Google Scholar]
  15. Martland T., Baxter P., Rittey C. Is there an agreed treatment for children in status epilepticus? Dev Med Child Neurol. 1998 Apr;40(4):286–287. [PubMed] [Google Scholar]
  16. Maytal J., Shinnar S., Moshé S. L., Alvarez L. A. Low morbidity and mortality of status epilepticus in children. Pediatrics. 1989 Mar;83(3):323–331. [PubMed] [Google Scholar]
  17. Morton L. D. Clinical experience with fosphenytoin in children. J Child Neurol. 1998 Oct;13 (Suppl 1):S19–S32. doi: 10.1177/0883073898013001061. [DOI] [PubMed] [Google Scholar]
  18. Murray C. S., Cohen A., Perkins T., Davidson J. E., Sills J. A. Morbidity in reflex sympathetic dystrophy. Arch Dis Child. 2000 Mar;82(3):231–233. doi: 10.1136/adc.82.3.231. [DOI] [PMC free article] [PubMed] [Google Scholar]
  19. Mäkelä J. P., Iivanainen M., Pieninkeroinen I. P., Waltimo O., Lahdensuu M. Seizures associated with propofol anesthesia. Epilepsia. 1993 Sep-Oct;34(5):832–835. doi: 10.1111/j.1528-1157.1993.tb02098.x. [DOI] [PubMed] [Google Scholar]
  20. Norris E., Marzouk O., Nunn A., McIntyre J., Choonara I. Respiratory depression in children receiving diazepam for acute seizures: a prospective study. Dev Med Child Neurol. 1999 May;41(5):340–343. doi: 10.1017/s0012162299000742. [DOI] [PubMed] [Google Scholar]
  21. O'Regan M. E., Brown J. K., Clarke M. Nasal rather than rectal benzodiazepines in the management of acute childhood seizures? Dev Med Child Neurol. 1996 Nov;38(11):1037–1045. doi: 10.1111/j.1469-8749.1996.tb15064.x. [DOI] [PubMed] [Google Scholar]
  22. Pollard A. J., Britto J., Nadel S., DeMunter C., Habibi P., Levin M. Emergency management of meningococcal disease. Arch Dis Child. 1999 Mar;80(3):290–296. doi: 10.1136/adc.80.3.290. [DOI] [PMC free article] [PubMed] [Google Scholar]
  23. Scott R. C., Besag F. M., Neville B. G. Buccal midazolam and rectal diazepam for treatment of prolonged seizures in childhood and adolescence: a randomised trial. Lancet. 1999 Feb 20;353(9153):623–626. doi: 10.1016/S0140-6736(98)06425-3. [DOI] [PubMed] [Google Scholar]
  24. Scott R. C., Surtees R. A., Neville B. G. Status epilepticus: pathophysiology, epidemiology, and outcomes. Arch Dis Child. 1998 Jul;79(1):73–77. doi: 10.1136/adc.79.1.73. [DOI] [PMC free article] [PubMed] [Google Scholar]
  25. Shepherd S. M. Management of status epilepticus. Emerg Med Clin North Am. 1994 Nov;12(4):941–961. [PubMed] [Google Scholar]
  26. Shinnar S., Berg A. T., Moshe S. L., O'Dell C., Alemany M., Newstein D., Kang H., Goldensohn E. S., Hauser W. A. The risk of seizure recurrence after a first unprovoked afebrile seizure in childhood: an extended follow-up. Pediatrics. 1996 Aug;98(2 Pt 1):216–225. [PubMed] [Google Scholar]
  27. Smith R. A., Martland T., Lowry M. F. Children with seizures presenting to accident and emergency. J Accid Emerg Med. 1996 Jan;13(1):54–58. doi: 10.1136/emj.13.1.54. [DOI] [PMC free article] [PubMed] [Google Scholar]
  28. Smyth R. L., Croft N. M., O'Hea U., Marshall T. G., Ferguson A. Intestinal inflammation in cystic fibrosis. Arch Dis Child. 2000 May;82(5):394–399. doi: 10.1136/adc.82.5.394. [DOI] [PMC free article] [PubMed] [Google Scholar]
  29. Stecker M. M., Kramer T. H., Raps E. C., O'Meeghan R., Dulaney E., Skaar D. J. Treatment of refractory status epilepticus with propofol: clinical and pharmacokinetic findings. Epilepsia. 1998 Jan;39(1):18–26. doi: 10.1111/j.1528-1157.1998.tb01269.x. [DOI] [PubMed] [Google Scholar]
  30. Tasker R. C. Emergency treatment of acute seizures and status epilepticus. Arch Dis Child. 1998 Jul;79(1):78–83. doi: 10.1136/adc.79.1.78. [DOI] [PMC free article] [PubMed] [Google Scholar]
  31. Treiman D. M., Meyers P. D., Walton N. Y., Collins J. F., Colling C., Rowan A. J., Handforth A., Faught E., Calabrese V. P., Uthman B. M. A comparison of four treatments for generalized convulsive status epilepticus. Veterans Affairs Status Epilepticus Cooperative Study Group. N Engl J Med. 1998 Sep 17;339(12):792–798. doi: 10.1056/NEJM199809173391202. [DOI] [PubMed] [Google Scholar]

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