Author/Editor		Grad, Anton
Title		Smernice za zdravljenje epileptičnega statusa pri odraslih
Translated title		Guidelines for treatment of status epilepticus in adults
Type		članek
Source		Med Razgl
Vol. and No.		Letnik 39, št. Suppl 10
Publication year		2000
Volume		str. 125-7
Language		slo
Abstract		Status epilepticus, defined as an epileptic seizure or series of seizures without regaining consciousness within at least 30 minutes, is a major medical emergency. It can cause permanent neurologic sequelae or death if appropriate therapy is too late. Furthermore, the administration of anti-epileptic drugs contributes to hemodynamic instability. Successful management is based on simultaneous multisystem support: ensuring cardiorespiratory stability and treatment of seizures. Intravenous, rectal or intranasal benzodiazepines (diazepam, midazolam), used as initial drug therapy and followed by phenytoin, phenobarbital or propofol, are effective in aborting seizures in the majority of patients. In the treatment of refractory status epilepticus, midazolam and propofol are recommended.The management of status epilepticus, therefore, requires a prompt comprehensive and dynamic approach and should be individualized depending on the patient's condition.
Summary		Epileptični status, definiran kot epileptični napad ali serija epileptičnih napadov, po katerem se zavest ne povrne v tridesetih minutah, predstavlja medicinsko nujnost Lahko pusti stalne nevrološke posledice ali celo povzroči smrt če je zdravljenje prepozno. Ob tem pa antiepileptiki sami doprinesejo k hemodinamski nestabilnosti. Uspešno zdravljenje sloni na istočasnem večsistemskem pristopu: zagotovitvi kardiorespiratorne stabilnosti in zdravljenju epileptičnih napadov. Intravenozni, rektalni ali intranazalni benzodiazepini (diazepam, midazolam) predstavljajo začetno terapijo, ki jim slede fenitoin, fenobarbiton ali propofol. Tako zdravljenje je učinkovito v večini primerov. V zdravljenju refraktarnega epileptičnega statusa svetujemo midazolam in propofol. Zdravljenje epileptičnega statusa torej zahteva takojšen, celosten in dinamičen pristop, ki ga moramo individualno prilagoditi bolnikovemu stanju.
Descriptors		STATUS EPILEPTICUS ADULT DELIVERY OF HEALTH CARE EMERGENCY MEDICAL SERVICES PATIENT CARE PLANNING GUIDELINES