학술논문

Pediatric Status Epilepticus: Treat Early and Avoid Delays.
Document Type
Article
Source
Pediatric Drugs. Jul2023, Vol. 25 Issue 4, p411-424. 14p.
Subject
*STATUS epilepticus
*TREATMENT delay (Medicine)
*NEUROLOGICAL emergencies
*HEALTH services accessibility
Language
ISSN
1174-5878
Abstract
Pediatric convulsive status epilepticus (cSE) is a neurologic emergency with potential for morbidity and mortality. Rapid treatment and escalation of therapies to achieve early seizure control is paramount in preventing complications and providing the best patient outcomes. Although guidelines recommend early treatment, cessation of out-of-hospital SE is undermined by treatment delay and inadequate dosing. Logistical challenges include prompt seizure recognition, first-line benzodiazepine (BZD) availability, comfort and expertise in administration of BZD, and timely arrival of emergency personnel. In-hospital, SE onset is additionally impacted by delays to first- and second-line treatment and availability of resources. This review presents an evidence-based, clinically oriented review of pediatric cSE, including its definitions and treatments. It provides evidence and rationale for timely treatment of first-line BZD treatment followed by prompt escalation to second-line antiseizure medication therapies for established SE. Treatment delays and barriers to care are discussed, with practical considerations for opportunities for areas of improvement in the initial treatment of cSE. [ABSTRACT FROM AUTHOR]