Management of patients with decompensation of epilepsy
https://doi.org/10.21518/2079-701X-2018-9-30-33
Abstract
Status epilepticus (SE) is a medical emergency when a seizure lasts without a breach of continuity or when seizures occur close together. The International Antiepileptic League assigns a key value in the new definition of SE to the dynamics of the SE progression. The identification of acute symptomatic status epilepticus is of practical importance. Pathophysiological processes occurring in a patient with SE can be divided into two phases: compensation and decompensation. The article provides the recommendations developed for each stage of medical care rendered to a patient with SE. 38 patients hospitalized with epileptic seizures for the period from January 2017 to April 2018 received medical examination and treatment. 7 patients had to be managed in the intensive care unit (18.4%). 64.3% of patients received parenteral therapy with valproate, 28.5% with levetiracetam, 7.1% additional anaesthesia and a third of patients underwent therapy correction with tableted forms of antiepileptic drugs. The availability of drugs is an important economic indicator at the present stage of medical care. Valproates, prolonged forms, including ready-made solutions for intravenous administration, continue to be ranked number one.
About the Author
Yu. A. Belova
M.F.Vladimirsky Moscow Regional Research Clinical Institute, State Budget Health Institution
Russian Federation
Russian Federation
References
1. Rossetti AO, Lowenstein DH. Management of refractory status epilepticus in adults: still more questions than answers. Lancet neurol, 2011, 10: 922-930. doi:10.1016/s1474-4422(11)70187-9.
2. Amcheslav skaya EV, Amtsheslavsky VG, Balkan skaya SV, Glazkova SV, Batysheva ТT. Status epilepticus in children. Guidelines No.30. Moscow. 2013, p 3.
3. Karlov VA. Definition and classification of status epilepticus (comments on the report of the International Antiepileptic League Commission). Zhurnal Nevrologii i Psikhiatrii im. S.S. Korsakova, Special Issue, 2016, 116 (9): 32-36. doi: 10.17116/jnevro20161169232-36.
4. Kotov AS, Eliseev YuV, Semenova EI. Status epilepticus. Mo dern view on the problem. Poliklinika, 2016, 3: 16-18.
5. Trinka E, Cock H, Hesdorffer D, Rosetti AO, Scheffer IE, Shinnar Sh, Shorvon S., Lowenstein D. HA definition and classification of status epilepticus – Report of the ILAE Task Forse on Claeeification of Status Epilepticus. Epilepsia, 2015, 56(10): 1515-1523.
6. Karlov VA. Status epilepticus. Epilepsy in children and adult women and men. M.: Medicine, 2010: 483-511.
7. Kotov AS. Generalized convulsive status epilepticus. RMJ, 2015, 12: 651.
8. Trofimova AM, Postnikova TYu., Zaitsev AV. The effect of status epilepticus on synaptic plasticity in the hippocampus. Materials of the scientific conference with international participation. Physics, Nanotechno logies and Telecommunications Institute. St. Petersburg, November 13-19, 2017 Publisher: Peter the Great St. Petersburg Polytechnic University, Federal State Autonomous Educational Institution of Higher Education (St. Petersburg). 2017: 519-522 DK: 612.825.
9. Lipatova LV, Rudakova IG, Sivakova NA, Kapustina ТV. Acute symptomatic epileptic seizures and status epilepticus. Zhurnal Nevrologii i Psikhiatrii im. S.S. Korsakova, 2015, 115 (4-1): 24-29. doi: 10.17116/jnevro20151154124-29.
10. Trinka E, Hofler J and Zerbs Ar. Causes of status epilepticus. Epilepsia, 2012, 53(Suppl. 4): 127–138
11. Limdi NA, Shimpi AV, Faught E, et al. Efficacy of rapid IV administration of valproic acid for status epilepticus. Neurology, 2005, 64(2): 353–355.
12. Peters CN, Pohlmann-Eden B. Intravenous valproate as an innovative therapy in seizure emergency situations including status epilepticus – experience in 102 adult patients. Seizure, 2005, 14(3): 164–169.
13. Order of the Ministry of Health of the Russian Federation No. 36n On Approval of Requirements for Packaging of Drugs and Medical Devices Used for Emergency Medical Care Packages and Kits of January 22, 2016 (registration No. 41191 of February 24, 2016bin the Ministry of Justice of the Russian Federation).
14. Trinka E, Shorvon S et al. Лечение эпилептического статуса в зависимости от стадии (modified Trinka E, 2007, Shovron et al 2008), Epilepsia, ILAE.
15. Kholin AA, Voronkova KV, Pylaeva OA, Petrukhin AS. Efficiency and safety of intravenous administration of valproates. Zhurnal Nevrologii i Psikhiatrii im. S.S. Korsakova, 2010, 110 (3): 55-59.
16. Sutter R, Marsch S, Fuhr P, Kaplan PW, Rüegg S. Anesthetic drugs in status epilepticus: risk or rescue? A 6-year cohort study. Neurology, 2014, 82(8): 656-664. doi:10.1212/wnl.0000000000000009.
17. Volkova YuV, Sidorenkova NB, Azarova ES. Status epilepticus -the algorithm of emergency care in pediatric practice. Actual problems of medicine in Russia and abroad. Collection of scientific papers on the results of an international scientific and practical conference. Publisher: Innovation Center for the Development of Education and Science. 2015: 190-192.
18. Kotov AS, Eliseev YuV, Semenova EI, Tokareva YuV, Romanova MV, Bunak MS, Rudakova IG. Status epilepticus in a patient with Rasmussen’s encephalitis. Almanakh Klinicheskoy Meditsiny, 2016, 44 (3): 363-368. doi: 10.18786/2072-0505-2016-44-3-363-368.
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For citations:
Belova YA. Management of patients with decompensation of epilepsy. Meditsinskiy sovet = Medical Council. 2018;(9):30-33. (In Russ.) https://doi.org/10.21518/2079-701X-2018-9-30-33
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