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Titolo:
Status epilepticus in older patients - Epidemiology and treatment options
Autore:
Waterhouse, EJ; DeLorenzo, RJ;
Indirizzi:
Virginia Commonwealth Univ, Med Coll Virginia, Dept Neurol, Richmond, VA 23298 USA Virginia Commonwealth Univ Richmond VA USA 23298 , Richmond, VA 23298 USA Virginia Commonwealth Univ, Med Coll Virginia, Comprehens Epilepsy Inst, Richmond, VA 23298 USA Virginia Commonwealth Univ Richmond VA USA 23298 , Richmond, VA 23298 USA
Titolo Testata:
DRUGS & AGING
fascicolo: 2, volume: 18, anno: 2001,
pagine: 133 - 142
SICI:
1170-229X(2001)18:2<133:SEIOP->2.0.ZU;2-W
Fonte:
ISI
Lingua:
ENG
Soggetto:
NONCONVULSIVE STATUS EPILEPTICUS; REFRACTORY STATUS EPILEPTICUS; CONVULSIVE STATUS EPILEPTICUS; GENERALIZED STATUS-EPILEPTICUS; CLONIC STATUS EPILEPTICUS; VALPROIC ACID; INTRAVENOUS PHENYTOIN; INFUSION; SAFETY; MIDAZOLAM;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
51
Recensione:
Indirizzi per estratti:
Indirizzo: Waterhouse, EJ Virginia Commonwealth Univ, Med Coll Virginia, Dept Neurol,POB 980599, Richmond, VA 23298 USA Virginia Commonwealth Univ POB 980599 Richmond VA USA 23298
Citazione:
E.J. Waterhouse e R.J. DeLorenzo, "Status epilepticus in older patients - Epidemiology and treatment options", DRUG AGING, 18(2), 2001, pp. 133-142

Abstract

Status epilepticus (SE) is a medical and neurological emergency that has been associated with significant morbidity and mortality. The most widely accepted definition of SE is more than 30 minutes of either continuous seizure activity, or intermittent seizures without full recovery of consciousnessbetween seizures. SE is a major clinical concern in the elderly population, both because it has increased incidence in the elderly compared with the general population. and because of concurrent medical conditions that are more likely to complicate therapy and worsen prognosis in elderly individuals. The incidence of SE in the elderly is almost twice that of the general population at 86 per 100 000 per year. With the anticipated growth of the elderly population, SE is likely to become an increasingly common problem facing clinicians, and an important public health issue. The elderly have the highest SE-associated mortality of any age group at 38%, and the very old elderly (>80 years of age) have a mortality of at least 50%. Acute or remote stroke is the most common aetiology of SE in the elderly. Nonconvulsive SE (NCSE) has a wide range of clinical presentations, ranging from confusion toobtundation. It occurs commonly in elderly patients who are critically illand in the setting of coma. Electroencephalogram is the only reliable method of diagnosing NCSE. The goal of treatment for SE is rapid cessation of clinical and electricalseizure activity. Most treatment protocols call for the immediate administration of an intravenous benzodiazepine, followed by phenytoin or fosphenytoin. Recent studies suggest that when this initial treatment of SE fails, little is gained by using additional standard drugs. General anaesthetic agents (such as pentobarbital, midazolam, or propofol) should be expeditiouslyemployed, although these treatments have their own potential complications. Intravenous valproic acid is a recent addition to the armamentarium of drugs for the treatment of SE, with a low risk of hypotension, respiratory depression and hypotension, making it a potentially useful drug for the treatment of SE in the elderly. However, further information is needed to establish its role in the overall treatment of SE.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 29/03/20 alle ore 08:34:33