thiopental and fosphenytoin

Status epilepticus is defined as epileptic seizure with the duration for over 30 min or clustered seizure without complete recovery of consciousness for 30 min or more. From the management point of view, therapeutic intervention is recommended for prolonged seizures for 5 min or more. Intranasal, buccal or intramuscular administration of midazolam is strongly evidence-based and highly recommended method for the treatment of prolonged seizures before the intravenous access. Diazepam or midazolam is the first choice as initial intravenous treatment. Intravenous bolus administration of fosphenytoin or phenobarbital is the second line treatment. General anesthesia using such as thiopental or propofol is indicated for refractory status epileptic, which should be managed in the intensive care unit.

Topics: Anesthesia, General; Diazepam; Drug Administration Routes; Evidence-Based Medicine; Humans; Hypothermia, Induced; Intensive Care Units; Midazolam; Phenobarbital; Phenytoin; Practice Guidelines as Topic; Propofol; Status Epilepticus; Thiopental; Time Factors

Factors contributing to the duration of a single convulsive seizure > 5 minutes were analyzed in 157 children. The medically treated episodes were compared with seizure episodes resolving without treatment (n = 27). Major differences were in age (p = 0.016) and etiology (p = 0.003), and the association between treatment delay and response became significant after 30 minutes when this was analyzed as a single variable (p = 0.003) in Cox regression analysis.

Topics: Administration, Rectal; Anticonvulsants; Benzodiazepines; Child, Preschool; Clinical Protocols; Disease Progression; Early Diagnosis; Epilepsy; Female; Humans; Infusion Pumps; Male; Phenobarbital; Phenytoin; Retrospective Studies; Secondary Prevention; Status Epilepticus; Thiopental; Time Factors; Treatment Outcome