J Clin Neurol.  2021 Jan;17(1):11-19. 10.3988/jcn.2021.17.1.11.

Antiepileptic Drug Therapy for Status Epilepticus

Affiliations
  • 1Department of Neurology, Chungnam National University Hospital, Chungnam National University College of Medicine, Daejeon, Korea
  • 2Department of Neurology, Keimyung University School of Medicine, Daegu, Korea
  • 3Department of Neurology, Soonchunhyang University College of Medicine, Cheonan Hospital, Cheonan, Korea
  • 4Department of Neurology, Konkuk University School of Medicine, Seoul, Korea
  • 5Department of Neurology, Seoul National University Hospital, Seoul, Korea
  • 6Department of Neurology, Samsung Noble County, Yongin, Korea
  • 7Department of Neurology, School of Medicine, Kyungpook National University, Daegu, Korea
  • 8Department of Neurology, Kyung Hee University Hospital at Gangdong, Seoul, Korea
  • 9Department of Neurology, Chonnam National University Hospital, Chonnam National University School of Medicine, Gwangju, Korea

Abstract

Status epilepticus (SE) is one of the most serious neurologic emergencies. SE is a condition that encompasses a broad range of semiologic subtypes and heterogeneous etiologies. The treatment of SE primarily involves the management of the underlying etiology and the use of antiepileptic drug therapy to rapidly terminate seizure activities. The Drug Committee of the Korean Epilepsy Society performed a review of existing guidelines and literature with the aim of providing practical recommendations for antiepileptic drug therapy. This article is one of a series of review articles by the Drug Committee and it summarizes staged antiepileptic drug therapy for SE. While evidence of good quality supports the use of benzodiazepines as the first-line treatment of SE, such evidence informing the administration of second- or third-line treatments is lacking; hence, the recommendations presented herein concerning the treatment of established and refractory SE are based on case series and expert opinions. The choice of antiepileptic drugs in each stage should consider the characteristics and circumstances of each patient, as well as their estimated benefit and risk to them. In tandem with the antiepileptic drug therapy, careful searching for and treatment of the underlying etiology are required.

Keyword

status epilepticus; seizure; antiepileptic drugs; benzodiazepines; anesthetics; drug therapy
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