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EPILEPTIC STATUS AND THERAPY
Medical facultyPristina , Kosovska Mitrovica , Kosovo*
Medical facultyPristina , Kosovska Mitrovica , Kosovo*
Medical facultyPristina , Kosovska Mitrovica , Kosovo*
Medical facultyPristina , Kosovska Mitrovica , Kosovo*
Health cetner Kosovska Mitrovica Kosovo*
Health cetner Kosovska Mitrovica Kosovo*
Published: 01.12.2008.
Volume 36, Issue 2 (2008)
pp. 89-96;
Abstract
Epileptic status is one of the most urgent conditions in medicine, whose positive outcome is directly dependent of adequate treatment. The estimation of epileptic status incidence is not available. According to population studies, the incidence varies from 16 to 18 at a sample of 100000 people. The status treatment consists of a line of procedures whose goal is to stop it in as little time as possible. Medication therapy is the basis of it, and it is needed that intravenous medications are used urgently in an adequate dose, at an adequate speed (intravenous burden dose), with an adequate symptomatic therapy and correction of eventual provocation status factors. General medications used to initially treat the status are benzodiazepines, fenitoin and fenobarbiton. Randomized studies have shown that lorazepam has pharmacokinetic advantages over diazepam and that it doesn't initiate respiratory depression as often as midazolam. Also, it is more efficient than fenitoin, and more efficient than fenobarbiton. Medication treatment is confirmed to be efficient at breaking the status at nearly all of the patients, but the final outcome depends on the initial cause. If the status cannot be ended by application of conventional doses of basic medications, then a refractory status may be discussed. It may be treated by a prolonged anesthesia using barbiturates, midazolam or lorazepam.
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