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Progress in Clinical Neurosciences: Status Epilepticus: A Critical Review of Management Options

Published online by Cambridge University Press:  02 December 2014

Eelco F.M. Wijdicks  and
Nicholas D. Lawn
Eelco F.M. Wijdicks
Affiliation:
Department of Neurology, Neurological-Neurosurgical ICU, Mayo Clinic, Rochester, Minnesota, USA
Nicholas D. Lawn
Affiliation:
Department of Neurology, Royal Perth, Hospital, Perth, Australia
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Abstract

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Although generalized tonic-clonic status epilepticus (SE) is frequently seen, an evidence-based approach to management is limited by a lack of randomized clinical studies. Clinical practice, therefore, relies on a combination of expert recommendations, local hospital guidelines and dogma based on individual preference and past successes. This review explores selected and controversial aspects of SE in adults and provides a critical appraisal of currently recommended management strategies.

Résumé:

RÉSUMÉ:

Bien que l’état de mal épileptique tonique-clonique généralisé soit observé fréquemment, l’élaboration d’une approche de traitement fondée sur des preuves scientifiques est limitée par le manque d’études cliniques randomisées. La pratique Clinique est donc basée sur une combinaison de recommandations d’experts, de lignes directrices émises par l’hôpital local et de dogmes basés sur les préférences individuelles et les succès du passé. Cette revue explore des aspects sélectionnés et controversés de l’état de mal épileptique chez les adultes et fournit une évaluation critique des stratégies thérapeutiques présentement recommandées.

Type
Review Article
Information
Canadian Journal of Neurological Sciences , Volume 29 , Issue 3 , August 2002 , pp. 206 - 215
Copyright
Copyright © Canadian Neurological Sciences Federation 2002

References

1. Working Group on Status Epilepticus. Treatment of convulsivestatus epilepticus. Recommendations of the Epilepsy Foundation of America’s working group on status epilepticus. JAMA 1993;270:854–859.CrossRefGoogle Scholar
2. Treiman, DM, Meyers, PD, Walton, NY, et al. A comparison of fourtreatments for generalized convulsive status epilepticus. N Engl J Med 1998;339:792–798.CrossRefGoogle Scholar
3. Gillam, FG. Status epilepticus. In: Wylie, E (Ed). The treatment ofepilepsy: principles and practice (2nd ed.). Baltimore: Williams and Wilkins, 1997:666–676.Google Scholar
4. Treiman, DM. Treatment of status epilepticus. In: Engel, J and Pedley, TA (Eds). Epilepsy: A comprehensive textbook. Philadelphia: Lippincott-Raven, 1997:1317–1323.Google Scholar
5. Eadie, MJ, Tyrer, JH. Anticonvulsant therapy, pharmacological basisand practice. (3rd ed.). New York: Churchill Livingstone, 1989.Google Scholar
6. Shorvon, S. Status epilepticus: its clinical features and treatment inchildren and adults. Cambridge, England: Cambridge University Press, 1994.CrossRefGoogle Scholar
7. Proposal for revised clinical and electroencephalographicclassification of epileptic seizures: from the Commission on Classification and Terminology of the International League against Epilepsy. Epilepsia 1981;22:489–501.CrossRefGoogle Scholar
8. Meldrum, B, Brierly, JB. Prolonged epileptic seizures in primates:ischemic cell change and its relation to ictal physiological events. Arch Neurol 1978;28:10–17.CrossRefGoogle Scholar
9. Meldrum, BS, Vigouroux, RA, Brierly, JB. Systemic factors andepileptic brain damage: prolonged seizures in paralyzed, artificially ventilated baboons. Arch Neurol 1973;29;82–87.CrossRefGoogle ScholarPubMed
10. Wasterlain, CG. Mortality and morbidity from serial seizures; anexperimental study. Epilepsia 1974;15:155–176.CrossRefGoogle Scholar
11. Nevander, G, Ingvar, M, Auer, R, Siesjo, BK. Status epilepticus inwell-oxygenated rats causes neuronal necrosis. Ann Neurol 1985;18:281–290.CrossRefGoogle ScholarPubMed
12. DeLorenzo, RJ, Hauser, WA, Towne, AR, et al. A prospective,population-based epidemiologic study of status epilepticus inRichmond, Virginia. Neurology 1996;46:1029–1035.CrossRefGoogle ScholarPubMed
13. Hesdorffer, DC, Logroscino, G, Cascino, G, Annegers, JF, Hauser, WA. Incidence of status epilepticus in Rochester, Minnesota, 1965-1984. Neurology 1998;50:735–741.CrossRefGoogle ScholarPubMed
14. Lowenstein, DH, Bleck, T, Macdonald, RL. It’s time to revise thedefinition of status epilepticus. Epilepsia 1999;40:120–122.CrossRefGoogle Scholar
15. Jordan, KG. Status epilepticus. A perspective from the neuroscienceintensive care unit. Neurosurg Clin N Am 1994;5:671–686.CrossRefGoogle ScholarPubMed
16. Alldredge, BK, Gelb, AM, Isaacs, SM, et al. A comparison oflorazepam, diazepam, and placebo for the treatment of out-of-hospital status epilepticus. N Engl J Med 2001;345: 631–637.CrossRefGoogle ScholarPubMed
17. Aminoff, MJ, Simon, RP. Status epilepticus: causes, clinical featuresand consequences in 98 patients. Am J Med 1980;69:657–666.CrossRefGoogle Scholar
18. Oxbury, JM, Whitty, CWM. Causes and consequences of statusepilepticus in adults: a study of 86 cases. Brain 1971;94:733–744.CrossRefGoogle Scholar
19. Cascino, G, Hesdorffer, DC, Logroscino, G, Hauser, WA. Treatment ofnonfebrile status epilepticus in Rochester, Minn, from 1965through 1984. Mayo Clin Proc 2001;76:39–44.CrossRefGoogle ScholarPubMed
20. Howell, SJ, Owen, L, Chadwick, DW. Pseudostatus epilepticus. Q J Med 1989;71:507–519.Google ScholarPubMed
21. Walker, MC, Howard, RS, Smith, SJ, et al. Diagnosis and treatmentof status epilepticus on a neurological intensive care unit. Q J Med 1996;89: 913–920.CrossRefGoogle Scholar
22. DeLorenzo, RJ, Waterhouse, EJ, Towne, AR, et al. Persistentnonconvulsive status epilepticus after the control of convulsivestatus epilepticus. Epilepsia 1998;39:833–840.CrossRefGoogle ScholarPubMed
23. Jaitly, R, Sgro, JA, Towne, AR, Ko, D, DeLorenzo, RJ. Prognosticvalue of EEG monitoring after status epilepticus: a prospective adult study. J Clin Neurophysiol 1997;14:326–334.CrossRefGoogle Scholar
24. Treiman, DM. Electroclinical features of status epilepticus. J Clin Neurophysiol 1995;12:343–362.CrossRefGoogle ScholarPubMed
25. Garzon, E, Fernandes, RMF, Sakamoto, AC. Serial EEG duringhuman status epilepticus: evidence for PLEDs as an ictal pattern. Neurology 2001;57:1175–1183.CrossRefGoogle Scholar
26. Pohlmann-Eden, B, Hoch, DB, Cochius, JI, Chiappa, KH. Periodiclateralized epileptiform discharges – a critical review. J ClinNeurophysiol 1996;13:519–530.Google ScholarPubMed
27. Nei, M, Lee, JM, Shanker, VL, Sperling, MR. The EEG and prognosisin status epilepticus. Epilepsia 1999;40:157–163.CrossRefGoogle Scholar
28. Meldrum, BS, Horton, RW. Physiology of status epilepticus inprimates. Arch Neurol 1973;28:1–9.CrossRefGoogle Scholar
29. Lothman, EW, Bertram, EH, Bekenstein, JW, Perlin, JB. Self-sustaining limbic status epilepticus induced by ’continuous’ hippocampal stimulation: electrographic and behavioral characteristics. Epilepsy Res 1989;3:107–119.CrossRefGoogle ScholarPubMed
30. Young, GB, Gilbert, JJ, Zochodne, DW. The significance ofmyoclonic status epilepticus in postanoxic coma. Neurology 1990;40:1843–1848.CrossRefGoogle ScholarPubMed
31. Van Ness, PC. Pentobarbital and EEG burst suppression in treatmentof status epilepticus refractory to benzodiazepines and phenytoin. Epilepsia 1990;31:61–67.CrossRefGoogle Scholar
32. DeGiorgio, CM. Burst-suppression patterns in status epilepticus. Theburst-suppression duration ratio: a marker of the end of clinical status epilepticus. J Epilepsy 1993;6:32–35.CrossRefGoogle Scholar
33. Krishnamurthy, KB, Drislane, FW. Depth of EEG suppression andoutcome in barbiturate anesthetic treatment for refractory statusepilepticus. Epilepsia 1999;40:759–762.CrossRefGoogle Scholar
34. Jantti, V, Eriksson, K, Hartikainen, K, Baer, GA. Epileptic EEGdischarges during burst suppression. Neuropediatrics 1994;25:271–273.CrossRefGoogle Scholar
35. Logroscino, G, Hesdorffer, DC, Cascino, G, Annegers, JF, Hauser, WA. Short-term mortality after a first episode of status epilepticus. Epilepsia 1997;38:1344–1349.CrossRefGoogle ScholarPubMed
36. Towne, AR, Pellock, JM, Ko, D, DeLorenzo, RJ. Determinants ofmortality in status epilepticus. Epilepsia 1994;35:27–34.CrossRefGoogle Scholar
37. Lowenstein, DH, Alldredge, BK. Status epilepticus at an urban publichospital in the 1980s. Neurology 1993;43:483–488.CrossRefGoogle Scholar
38. DeLorenzo, RJ, Garnett, LK, Towne, AR, et al. Comparison of statusepilepticus with prolonged seizure episodes lasting from 10 to 29 minutes. Epilepsia 1999;40:164–169.CrossRefGoogle Scholar
39. Waterhouse, EJ, Garnett, LK, Towne, AR, et al. Prospective population-based study of intermittent and continuous convulsive status epilepticus in Richmond, Virginia. Epilepsia 1999;40:752–758.CrossRefGoogle ScholarPubMed
40. Cascino, GD, Hesdorffer, D, Logroscino, G, Hauser, WA. Morbidityof nonfebrile status epilepticus in Rochester, Minnesota, 1965-1984. Epilepsia 1998;39:829–832.CrossRefGoogle ScholarPubMed
41. Hesdorffer, DC, Logroscino, G, Cascino, G, Annegers, JF, Hauser, WA. Risk of unprovoked seizure after acute symptomatic seizure: effect of status epilepticus. Ann Neurol 1998;44: 908–912.CrossRefGoogle ScholarPubMed
42. Hauser, WA, Rich, SS, Annegers, JF, Anderson, VE. Seizurerecurrence after a 1st unprovoked seizure: an extended follow-up. Neurology 1990;40:1163–1170.CrossRefGoogle Scholar
43. Hauser, WA, Anderson, VE, Loewenson, RB, McRoberts, SM. Seizurerecurrence after a first unprovoked seizure. N Engl J Med 1982;307:522–528.CrossRefGoogle Scholar
44. Alldredge, BK, Wall, DB, Ferriero, DM. Effect of prehospitaltreatment on the outcome of status epilepticus in children. Pediatr Neurol 1995;12:213–216.CrossRefGoogle ScholarPubMed
45. Martin, PJ, Millac, PA. Status epilepticus: management and outcomeof 107 episodes. Seizure 1994;3:107–113.CrossRefGoogle Scholar
46. Lowenstein, DH, Alldredge, BK. Current concepts: status epilepticus. N Engl J Med 1998;338:970–976.CrossRefGoogle Scholar
47. Shaner, DM, McCurdy, SA, Herring, MO, Gabor, AJ. Treatment ofstatus epilepticus: a prospective comparison of diazepam and phenytoin versus phenobarbitone and optional phenytoin. Neurology 1998;38:202–207.CrossRefGoogle Scholar
48. Leppik, IE, Derivan, AT, Homan, RW, et al. Double-blind study oflorazepam and diazepam in status epilepticus. JAMA 1983;249:1452–1454.CrossRefGoogle ScholarPubMed
49. Walker, JE, Homan, RW, Vasko, MR, et al. Lorazepam in statusepilepticus. Ann Neurol 1979;6:207–213.CrossRefGoogle Scholar
50. Chiulli, DA, Terndup, TE, Kanter, RK. The influence of diazepam orlorazepam on the frequency of endotracheal intubation in childhood status epilepticus. J Emerg Med 1991;9:13–17.CrossRefGoogle ScholarPubMed
51. Greenblatt, DJ, Divoll, M. Diazepam versus lorazepam: relationshipof drug distribution to duration of clinical action. Adv Neurol 1983;34:487–491.Google Scholar
52. Sorel, L, Mechler, L, Harmant, J. Comparative trial of intravenouslorazepam and clonazepam in status epilepticus. Clin Ther 1981;4:326–336.Google Scholar
53. Rey, E, Treluyer, JM, Pons, G. Pharmacokinetic optimization ofbenzodiazepine therapy for acute seizures. Focus on deliveryroutes. Clin Pharmacokinet 1999;36:409–424.CrossRefGoogle Scholar
54. Raines, A, Henderson, TR, Swinyard, EA, Dretchen, KL. Comparisonof midazolam and diazepam by the intramuscular route for the control of seizures in a mouse model of status epilepticus. Epilepsia 1990;31:313–317.CrossRefGoogle Scholar
55. Towne, AR, DeLorenzo, RJ. Use of intramuscular midazolam forstatus epilepticus. J Emerg Med 1999;17:323–328.CrossRefGoogle ScholarPubMed
56. Uthman, BM, Wilder, BJ, Ramsay, RE. Intramuscular use offosphenytoin: an overview. Neurology 1996;46:S24S-28.CrossRefGoogle ScholarPubMed
57. Delgado-Escueta, AV, Enrile-Bacsal, F. Combination therapy forstatus epilepticus: intravenous diazepam and phenytoin. Adv Neurol 1983;34:477–485.Google ScholarPubMed
58. Osorio, I, Reed, RC. Treatment of refractory generalized tonic-clonicstatus epilepticus with pentobarbital anesthesia after high-dosephenytoin. Epilepsia 1989;30:464–471.CrossRefGoogle Scholar
59. Bleck, TP. Management approaches to prolonged seizures and statusepilepticus. Epilepsia 1999;40:S59-63; discussion S64-S66.CrossRefGoogle Scholar
60. Walton, NY, Uthman, BM, Yafi, KE, Kim, JM, Treiman, DM. Phenytoin penetration into brain after administration of phenytoin or fosphenytoin. Epilepsia 1999;40:153–156.CrossRefGoogle ScholarPubMed
61. O’Brien, TJ, Cascino, GD, So, EL, Hanna, DR. Incidence and clinicalconsequence of the purple glove syndrome in patients receiving intravenous phenytoin. Neurology 1998;51:1034–1039.CrossRefGoogle ScholarPubMed
62. Cranford, RE, Leppik, IE, Patrick, B, Anderson, CB, Kostick, B. Intravenous phenytoin: clinical and pharmacokinetic aspects. Neurology 1978;28:874–880.CrossRefGoogle ScholarPubMed
63. Donovan, PJ, Cline, D. Phenytoin administration by constantintravenous infusion: selective rates of administration. Ann Emerg Med 1991;20:139–142.CrossRefGoogle Scholar
64. Bertz, RJ, Howrie, DL. Diazepam by continuous intravenousinfusion for status epilepticus in anticonvulsant hypersensitivity syndrome. Ann Pharmacother 1993;27:298–301.CrossRefGoogle ScholarPubMed
65. Walton, NY, Treiman, DM. Valproic acid treatment of experimentalstatus epilepticus. Epilepsy Res 1992;12:199–205.CrossRefGoogle ScholarPubMed
66. Bolanos, AR, Sarkisian, M, Yang, Y, et al. Comparison of valproateand phenobarbital treatment after status epilepticus in rats. Neurology 1998;51:41–48.CrossRefGoogle ScholarPubMed
67. Venkataraman, V, Wheless, JW. Safety of rapid intravenous infusionof valproate loading doses in epilepsy patients. Epilepsy Res 1999;35:147–153.CrossRefGoogle Scholar
68. Limdi, N, Faught, RE. The safety of rapid valproic acid infusion. Epilepsia 2000;41:1342-1345.CrossRefGoogle ScholarPubMed
69. Uberall, MA, Trollman, R, Wunsiedler, U, Wenzel, D. Intravenousvalproate in pediatric epilepsy patients with refractory status epilepticus. Neurology 2000;54:2188–2199.CrossRefGoogle ScholarPubMed
70. The Collaborative Eclampsia Trial Group. Which anticonvulsant forwomen with eclampsia? Evidence from the Collaborative Eclampsia Trial. Lancet 1995;345:1455–1463.CrossRefGoogle Scholar
71. Link, MJ, Anderson, RE, Meyer, FB. Effects of magnesium sulfate onpentylenetetrazol-inducedstatusepilepticus. Epilepsia 1991;32:543–549.CrossRefGoogle Scholar
72. Krauss, GL, Kaplan, P, Fisher, RS. Parenteral magnesium sulfate failsto control electroshock and pentylenetetrazol seizures in mice. Epilepsy Res 1989;4:201–206.CrossRefGoogle Scholar
73. Karceski, S, Morrell, M, Carpenter, D. The expert consensusguideline series-treatment of epilepsy. Epilepsy and Behavior 2001;2:(Suppl) A1-A50.Google Scholar
74. Herkes, GK, Wszolek, ZK, Westmoreland, BF, Klass, DW. Effects ofmidazolam on electroencephalograms of seriously ill patients. Mayo Clin Proc 1992;67:334–338.CrossRefGoogle Scholar
75. Igatua, J, Silver, P, Maytal, J, Sagy, M. Midazolam coma for refractorystatus epilepticus in children. Crit Care Med 1999;27:1982–1985.CrossRefGoogle Scholar
76. Parent, JM, Lowenstein, DH. Treatment of refractory generalizedstatus epilepticus with continuous infusion of midazolam. Neurology 1994;44:1837–1840.CrossRefGoogle Scholar
77. Kumar, A, Bleck, T. Intravenous midazolam for the treatment ofrefractory status epilepticus. Crit Care Med 1992;20:438–488.CrossRefGoogle Scholar
78. Fountain, NB, Adams, RE. Midazolam treatment of acute and refractorystatus epilepticus. Clin Neuropharmacol 1999;22:261–267.Google Scholar
79. Claassen, J, Hirsch, LJ, Emerson, RG, et al. Continuous EEGmonitoring and midazolam infusion for refractory nonconvulsive status epilepticus. Neurology 2001;57:1036–1042.CrossRefGoogle Scholar
80. Brown, LA, Levin, GM. Role of propofol in refractory statusepilepticus. Ann Pharmacother 1998;32:1053–1059.CrossRefGoogle Scholar
81. Stecker, MM, Kramer, TH, Raps, EC, et al. Treatment of refractorystatus epilepticus with propofol: clinical and pharmacokinetic findings. Epilepsia 1998;39:18–26.CrossRefGoogle Scholar
82. Prasad, A, Worrall, BB, Bertram, EH, Bleck, TP. Propofol andmidazolam in the treatment of refractory status epilepticus. Epilepsia 2001;42:380–386.CrossRefGoogle ScholarPubMed
83. Sneyd, JR. Excitatory events associated with propofol anaesthesia: areview. J R Soc Med 1992;85:288–291.CrossRefGoogle Scholar
84. Orser, B. Propofol-induced neuroexcitation and receptordesensitization. Can J Anaesth 1994;41:366–371.CrossRefGoogle Scholar
85. Finley, GA, MacManus, B, Sampson, SE, Fernandez, CV, Retallick, R. Delayed seizures following sedation with propofol. Can J Anaesth 1993;40:863–865.CrossRefGoogle ScholarPubMed
86. Bevan, JC. Propofol-related convulsions. Can J Anaesth 1993;40:805–809.CrossRefGoogle ScholarPubMed
87. Hewitt, PB, Chu, DL, Polkey, CE, Binnie, CD. Effect of propofol onthe electrocorticogram in epileptic patients undergoing corticalresection. Br J Anaesth 1999;82:199–202.CrossRefGoogle Scholar
88. Cremer, OL, Moons, KG, Bouman, EA, et al. Long-term propofolinfusion and cardiac failure in adult head-injured patients. Lancet 2001; 357:117–118.CrossRefGoogle ScholarPubMed
89. Crawford, TO, Mitchell, WG, Fishman, LS, Snodgrass, SR. Very-high-dose phenobarbital for refractory status epilepticus in children. Neurology 1988;38:1035–1040.CrossRefGoogle ScholarPubMed
90. Lowenstein, DH, Aminoff, MJ, Simon, RP. Barbiturate anesthesia inthe treatment of status epilepticus: clinical experience with 14 patients. Neurology 1988;38:395–400.CrossRefGoogle Scholar
91. Yaffe, K, Lowenstein, DH. Prognostic factors of pentobarbitaltherapy for refractory generalized status epilepticus. Neurology 1993;43:895–900.CrossRefGoogle ScholarPubMed
92. Young, GB, Blume, WT, Bolton, CF, et al. Anesthetic barbiturates inrefractory status epilepticus. Can J Neurol Sci 1998;7:291–292.CrossRefGoogle Scholar
93. Brown, A, Horton, J. Status epilepticus treated by intravenousinfusions of thiopentone sodium. Br Med J 1967;1:27–28.CrossRefGoogle ScholarPubMed
94. Roesch, C, Haselby, KA, Paradise, RR, et al. Comparison of cardio-vascular effects of thiopental and pentobarbital at equivalent levels of CNS depression. Anesth Analg 1983; 62:749–753.CrossRefGoogle Scholar
95. Moudgill, GC. Update on anaesthesia and the immune response. Can Anaesth Soc J 1986; 33:S54-S60.Google Scholar
96. Kinoshita, H, Nakagawa, E, Iwasaki, Y, Hanaoka, S, Sugai, K. Pentobarbital therapy for status epilepticus in children: timing of tapering. Pediatr Neurol 1995;13:164–168.CrossRefGoogle ScholarPubMed
97. Delgado-Escueta, AV, Wasterlain, C, Treiman, DM, Porter, RJ. Statusepilepticus: summary. Adv Neurol 1983;34:537–541.Google Scholar
98. Delgado-Escueta, AV, Wasterlain, C, Treiman, DM, Porter, RJ. Management of status epilepticus. N Eng J Med 1982;306:1337–1340.CrossRefGoogle ScholarPubMed
99. Modica, PA, Tempelhoff, R, White, PF. Pro- and anticonvulsanteffects of anesthetics (part 1). Anesth Analg 1990;70:303–315.Google Scholar
100. Kofke, WA, Towfighi, J, O’Connell, BK, Derr, J, Hawkins, RA. Neuropathological effects of anesthetics used to stop status epilepticus in rats. Anesthesiol Rev 1987;15:27–28.Google Scholar
101. Kofke, WA, Towfighi, J, Garman, RH, et al. Effects of anesthetics onneuropathological sequelae of status epilepticus in rats. Anesth Analg 1993;77:330–337.CrossRefGoogle ScholarPubMed
102. Murao, K, Shingu, K, Tsushima, K, et al. The anticonvulsant effectsof volatile anesthetics on penicillin-induced status epilepticus incats. Anesth Analg 2000;90:142–147.CrossRefGoogle Scholar
103. Kofke, WA, Snider, MT, Young, RSK, Ramer, JC. Prolonged low flowisoflurane anesthesia for status epilepticus. Anesthesiology 1985;62:653–656.CrossRefGoogle ScholarPubMed
104. Kofke, WA, Young, RSK, Davis, P, et al. Isoflurane for refractory statusepilepticus: a clinical series. Anesthesiology 1989;71:653–659.CrossRefGoogle Scholar
105. Ropper, AH, Kofke, WA, Bromfield, EB, Kennedy, SK. Comparisonof isoflurane, halothane and nitrous oxide in status epilepticus(letter). Ann Neurol 1986;19:98–99.CrossRefGoogle Scholar
106. Iijima, T, Nakamura, Z, Iwao, Y, Sankawa, H. The epileptogenic properties of the volatile anesthetics sevoflurane and isoflurane in patients with epilepsy. Anesth Analg 2000;91: 989–995.CrossRefGoogle ScholarPubMed
107. Sato, K, Shamoto, H, Kato, M. Effect of sevoflurane on electro-corticogram in normal brain. J Neurosurg Anesthesiol 2002;14:63–65.CrossRefGoogle Scholar
108. Walker, IA, Slovis, CM. Lidocaine in the treatment of statusepilepticus. Acad Emerg Med 1997;4:918–922.Google Scholar
109. De Toledo, JC. Lidocaineand seizures. Ther Drug Monit 2000;22:320–322.CrossRefGoogle ScholarPubMed
110. Pascual, J, Ciudad, J, Berciano, J. Role of lidocaine in managingstatus epilepticus. J Neurol Neurosurg Psychiatry 1992;55: 49–51.CrossRefGoogle ScholarPubMed
111. Sheth, RD, Gidal, BE. Refractory status epilepticus: response toketamine. Neurology 1998;51:1765–1766.CrossRefGoogle Scholar