Talk:Status epilepticus

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[edit] We've

We've got almost 20 references on lidocaine, many of which are in Japanese. Is there any way for making this tighter? I also don't think animal studies are immensely helpful here. JFW | T@lk 13:04, 15 July 2005 (UTC)

The abstracts themselves aren't in Japanese, and there's only one reference I can find to a lidocaine-induced seizure in humans.
Maybe I could lose a few of the rat studies.

If there's only one reference about lidocaine-induced seizures it may not be very common and therefore may not even need to be mentioned. I think we need more outline articles from a clinical point-of-view. JFW | T@lk 16:21, 15 July 2005 (UTC)

Actually, I was able to find two more cases, which I didn't include because just saying that it's a proconvulsant at doses above 3 mg/kg was enough. Also, the 5-8 mg/kg dose used in epidurals has been known to cause seizures when the needle bumps into a vein and it becomes an intravenous infusion instead.

By doing this, I was able to get rid of all the animal studies.

Well, all of the ones on lidocaine.Rmky87 23:53, 30 July 2005 (UTC)

Is there another drug name missing from this paragraph? (i.e. The pharmacological effects of what were longer lasting than diazepam?) Introspensive 20:51, 28 February 2006 (UTC)

"Shortly after it was introduced in 1963, diazepam became the first choice for SE. Even though other benzodiazepines such as clonazepam were useful, diazepam was relied upon almost exclusively. This began to change in 1975 with a preliminary study conducted by Waltregny and Dargent, who found that its pharmacological effects were longer lasting than those of an equal dose of diazepam.[3] This meant it did not have to be repeatedly injected like diazepam,[4] the effects of which would wear off 5-15 minutes later in spite of its 30-hour half-life."

[edit] Some further structuring of the article

I think it would be helpful to extend the article to currently used typifying of SE's accepted internationally by neurology/epileptology organizations (i.e., instead of dichotomisation only to convulsive and nonconvulsive SE's, (1)generalised tonic-clonic seizure status, (2)convulsive and nonconvulsive simple- or complex-focal seizures status, (3)absence status (generalised nonconvulsive seizure status) and (4)"subtle status epilepticus").

I think, that the overview of medicamentous treatment options should be "staged" (i.e., 1) BZD, if not effective, than 2) PHE or VAL, if not effective, than 3) BARBs, if not effective, than 4) general anesthesia ± muscle (curaremimetic) relaxation.

In the first-line treatment options, use of lorazepam IV should be stressed, as some reliable sources suggests that the anticonvulsive effect of IV lorazepam lasts for substantialy longer periods than that of IV diazepam and is more versatile than that of IV clonazepam. (thus, http://dgn.dgni.de/132.0.html suggests IV lorazepam to be the first-line-option of the step 1) of the "medication ladder", followed by IV clonazepam and at last, by IV diazepam)

Also, in my opinion, the IV administered valproate (sodium valproate inj. sol., parenteral equivalent to valproate/divalproex), should be added as a possible option in step 2) of the "medication ladder" (i.e. if the SE is BZD-refractory), along with phenytoin. German Neurologic Society does so.--Spiperon 20:41, 15 October 2006 (UTC)

[edit] Ref style

I'm updating this article's reference style to Cite.php; the current reference section is unmanageably long, and the new style is much easier to use. If anyone has any objections, please feel free to revert. Fvasconcellos (t·c) 19:38, 7 October 2007 (UTC)