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Acute Systemic Complications of Convulsive Status Epilepticus-A Systematic Review

Sutter, Raoul and Dittrich, Tolga and Semmlack, Saskia and Rüegg, Stephan and Marsch, Stephan and Kaplan, Peter W.. (2018) Acute Systemic Complications of Convulsive Status Epilepticus-A Systematic Review. Critical Care Medicine, 46 (1). pp. 138-145.

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Official URL: http://edoc.unibas.ch/58094/

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Abstract

Objectives: Status epilepticus is a neurologic emergency with high morbidity and mortality requiring neurointensive care and treatment of systemic complications. This systematic review compiles the current literature on acute systemic complications of generalized convulsive status epilepticus in adults and their immediate clinical impact along with recommendations for optimal neurointensive care.
Data Sources: We searched PubMed, Medline, Embase, and the Cochrane library for articles published between 1960 and 2016 and reporting on systemic complications of convulsive status epilepticus.
Study Selection: All identified studies were screened for eligibility by two independent reviewers.
Data Extraction: Key data were extracted using standardized data collection forms.
Data Synthesis: Thirty-two of 3,046 screened articles were included. Acute manifestations and complications reported in association with generalized convulsive status epilepticus can affect all organ systems fueling complex cascades and multiple organ interactions. Most reported complications result from generalized excessive muscle contractions that increase body temperature and serum potassium levels and may interfere with proper and coordinated function of respiratory muscles followed by hypoxia and respiratory acidosis. Increased plasma catecholamines can cause a decay of skeletal muscle cells and cardiac function, including stress cardiomyopathy. Systemic complications are often underestimated or misinterpreted as they may mimic underlying causes of generalized convulsive status epilepticus or treatment-related adverse events.
Conclusions: Management of generalized convulsive status epilepticus should center on the administration of antiseizure drugs, treatment of the underlying causes, and the attendant systemic consequences to prevent secondary seizure-related injuries. Heightened awareness, systematic clinical assessment, and diagnostic workup and management based on the proposed algorithm are advocated as they are keys to optimal outcome. (Crit Care
Med 2018; 46:138–145)
Key Words: convulsive status epilepticus; neurocritical care; neurointensive care treatment; systemic complications
Faculties and Departments:03 Faculty of Medicine
03 Faculty of Medicine > Bereich Medizinische Fächer (Klinik)
03 Faculty of Medicine > Departement Klinische Forschung > Bereich Medizinische Fächer (Klinik)
03 Faculty of Medicine > Bereich Medizinische Fächer (Klinik) > Intensivmedizin > Intensivmedizin (Marsch)
03 Faculty of Medicine > Departement Klinische Forschung > Bereich Medizinische Fächer (Klinik) > Intensivmedizin > Intensivmedizin (Marsch)
03 Faculty of Medicine > Bereich Medizinische Fächer (Klinik) > Neurologie
03 Faculty of Medicine > Departement Klinische Forschung > Bereich Medizinische Fächer (Klinik) > Neurologie
UniBasel Contributors:Sutter, Raoul Christian
Item Type:Article, refereed
Article Subtype:Research Article
Publisher:Wolters Kluwer
ISSN:0090-3493
e-ISSN:1530-0293
Note:Publication type according to Uni Basel Research Database: Journal article
Identification Number:
Last Modified:17 Apr 2018 18:00
Deposited On:17 Apr 2018 18:00

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