Медицина неотложных состояний (Apr 2024)
Status epilepticus: modern views on classification, typology, methods of diagnosis and treatment with third-generation anticonvulsants (review)
Abstract
Status epilepticus (SE) is a medical emergency associated with high morbidity and mortality. The guidelines of the International League Against Epilepsy use a stepwise approach to the treatment of SE depending on the response to treatment. Benzodiazepines are commonly used as initial therapy for SE. However, in approximately 40 % of cases of convulsive SE when benzodiazepines are prescribed, no improvement is observed, which indicates the occurrence of a refractory SE. For its treatment, intravenous anticonvulsants such as fosphenytoin, valproate or levetiracetam are used. But even this therapy can be ineffective in 31–47 % of cases, which is due to the development of refractory or super-refractory SE. To combat them, additional anti-seizure drugs are prescribed.
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