What is super refractory status epilepticus?

Super-refractory status epilepticus is a status epilepticus that continues for ≥24 hours despite anesthetic treatment, or recurs on an attempted wean of the anesthetic regimen. Both can occur in patients known to have epilepsy or de novo, with increasing recognition of autoimmune and genetic causes.

Which type of status epilepticus is most common?

What Happens in Status Epilepticus? There are two main forms of SE — convulsive and nonconvulsive. The convulsive type is more common and more dangerous.

What causes refractory status epilepticus?

Most of the causes of RSE can be identified within 24-72 hours of presentation, as it is commonly due to an obvious acute brain injury (stroke, trauma, etc.) or serious acute medical illness. RSE may also occur in people with epilepsy (also known as a seizure disorder).

What’s new in refractory status epilepticus?

‘New-onset refractory status epilepticus is a clinical presentation, not a specific diagnosis, in a patient without active epilepsy or other pre-existing relevant neurological disorder, with new-onset of refractory status epilepticus without a clear acute or active structural, toxic or metabolic cause.

How is refractory status epilepticus treated?

Management of refractory status epilepticus involves treatment of an underlying etiology in addition to intravenous anesthetics and antiepileptic drugs. Alternative treatment options including diet therapies, electroconvulsive therapy, and surgical resection in case of a focal lesion should be considered.

How is refractory epilepsy treated?

Surgery. Surgery may be especially helpful if you have refractory partial epilepsy. Your doctor may recommend surgery if you still have seizures after trying two or three antiepilepsy medicines. During the procedure, the doctor will remove the part of your brain that’s starting the seizures.

Which patient age group has the lowest incidence of status epilepticus?

The incidence of SE is 15.5/100 000 in the 60-69 age group, 21.5/100 000 in the 70-79 age group and 25.9/100 000 in persons 80 and older.

How common is Norse?

NORSE is a rare disorder with one estimate being around 3,200 cases per year in the U.S. Underreporting and misdiagnoses are likely since the term itself is new and not well established. There is no evidence as yet for a genetic basis for NORSE; and no reports of NORSE striking more than once in a family.

Is favorable outcome possible after prolonged refractory status epilepticus?

In many series, prolonged, refractory SE has a mortality of 30% to 50%, and several studies indicate that most survivors have a substantial decline in functional status. Nevertheless, several reports demonstrate that good functional outcome is possible even after several days of SE and coma induction.

What medication has been effective in treating status epilepticus that is refractory to phenobarbital?

Lorazepam is the most commonly used agent, used at a dose of 0.1 mg/kg given in dose of 2 mg/min to a maximum of 8 mg. Lorazepam was shown to be successful in 64.9% patients as the first line compared to 58.2% success with phenobarbital and 55.8 % with Diazepam plus Phenytoin.

How common is refractory epilepsy?

About one-third of people with epilepsy will eventually develop refractory epilepsy. This means that medicines don’t work well, or at all, to control the seizures.

How is refractory epilepsy diagnosed?

How is refractory epilepsy diagnosed? Your healthcare provider will likely ask you many questions about your seizures. You will likely also have a test called an electroencephalogram (EEG). This involves placing electrodes on your scalp to measure your brain’s activity.

How common is status epilepticus?

Status epilepticus is very rare. Most people with epilepsy will never have it. This condition is more common in young children and elderly adults.

What age group has the highest incidence of epilepsy?

Epilepsy most commonly begins in childhood or in older adulthood, although it can begin at any age. People over 65 years of age have the highest incidence of epilepsy of any age, accounting for almost a quarter of cases of new onset epilepsy.

Do I have Viking blood?

And experts say surnames can give you an indication of a possible Viking heritage in your family, with anything ending in ‘son’ or ‘sen’ likely to be a sign. Other surnames which could signal a Viking family history include ‘Roger/s’ and ‘Rogerson’ and ‘Rendall’.

Do Vikings still exist in 2021?

No, to the extent that there are no longer routine groups of people who set sail to explore, trade, pillage, and plunder. However, the people who did those things long ago have descendants today who live all over Scandinavia and Europe.

What percentage of status epilepticus cases result in fatality?

Status epilepticus–related mortality in our study is significantly lower than previous estimates. Prior studies report an annual status epilepticus incidence of 10 to 41 per 100 000 persons,1-5 and mortality estimates range from approximately 10% to 20%.

Why is Ativan given for seizures?

Ativan binds to a type of GABA receptor, called GABAA, and activates it in a similar way to GABA. GABA is a signaling molecule that inhibits nerve cell signaling. Through this mechanism, Ativan is thought to reduce the uncontrolled firing of neurons that causes seizures.

How many people have refractory epilepsy in the US?

This condition is also referred to as intractable, medically refractory, or pharmacoresistant epilepsy. As many as 20 to 40 percent of patients with epilepsy (roughly 400,000 people living in the United States) are likely to have refractory epilepsy.

What percentage of patients with epilepsy will have medically refractory epilepsy?