Logomark

Neurology

Seizures

Seizures are a common complication in the ICU, often arising from neurological, metabolic, or systemic disorders. Early recognition and intervention are crucial to prevent status epilepticus, brain injury, and secondary complications.

This section covers:

  • Seizures in the ICU: Prevention, treatment, and monitoring strategies.
  • Status Epilepticus: Evidence-based guidelines on acute management and escalation protocols.

Timely EEG monitoring, targeted anticonvulsant therapy, and a structured treatment approach are essential to optimize outcomes for critically ill patients with seizures.


Seizures in the ICU

Review

Seizures in the ICU

Prevention, Treatment, and Monitoring of Seizures in the Intensive Care Unit

Micheal Strein et al., Journal of Clinical Medicine (2019)

What’s inside

This article discusses the prevention, treatment, and monitoring of seizures in the ICU, providing evidence-based strategies for managing seizure activity in critically ill patients. It covers the use of anticonvulsants, monitoring techniques, and when to escalate care.

Why it’s relevant

Seizures are a common and serious complication in the ICU, often associated with neurological or metabolic conditions. Proper management is crucial to prevent further complications, making this article highly relevant for ICU professionals.

Key focus

  • Prevention strategies for seizures in critically ill patients
  • Pharmacologic treatment, including first-line and second-line anticonvulsants
  • Monitoring techniques, including EEG and clinical signs
  • Management of status epilepticus and refractory seizures
  • Considerations for post-seizure care and long-term prevention

Takeaway

This article provides essential guidance for ICU professionals in managing seizures, with a focus on prevention, prompt treatment, and continuous monitoring to optimize patient outcomes.


Status epilepticus

Guideline

Status epilepticus

Evidence-Based Guideline: Treatment of Convulsive Status Epilepticus in Children and Adults: Report of the Guideline Committee of the American Epilepsy Society

Tracy Glauser et al., Epilepsy Currents (2016)

What’s inside

This evidence-based guideline provides recommendations for the treatment of convulsive status epilepticus in both children and adults, offering a step-by-step approach to management in emergency and ICU settings. It includes first-line and second-line therapies, as well as guidance on when to escalate care.

Why it’s relevant

Convulsive status epilepticus is a medical emergency that can lead to brain injury and other severe complications. These guidelines are essential for ICU professionals to manage this critical condition effectively and improve patient outcomes.

Key focus

  • Initial management and stabilization, including airway and respiration support
  • First-line and second-line anticonvulsant therapy
  • When to escalate treatment and consider advanced interventions like anesthesia
  • Post-status care, including monitoring and prevention of recurrence
  • Specific considerations for both pediatric and adult populations

Takeaway

This guideline provides crucial recommendations for ICU professionals managing convulsive status epilepticus, offering evidence-based strategies to stabilize patients, manage seizures, and prevent long-term complications.

Guideline

Status epilepticus

EFNS guideline on the management of status epilepticus

H. Meierkord et al., European Journal of Neurology (2006)

What’s inside

This article presents the EFNS guideline on the management of status epilepticus, offering evidence-based recommendations for the diagnosis, treatment, and management of this neurological emergency. It covers both acute and refractory status epilepticus in adults and children.

Why it’s relevant

Status epilepticus is a life-threatening condition that requires rapid intervention. ICU professionals need clear guidelines for managing this emergency, making these recommendations essential for effective care and improved patient outcomes.

Key focus

  • Immediate treatment strategies, including airway management and first-line anticonvulsants
  • Second-line treatments and escalation protocols for refractory status epilepticus
  • Use of anesthetic agents in prolonged seizures
  • Monitoring, including EEG, and post-seizure care
  • Special considerations for pediatric and adult patients

Takeaway

This guideline offers ICU professionals essential strategies for managing status epilepticus, emphasizing timely interventions and escalation when needed to prevent complications and improve survival outcomes.

Review

Status epilepticus

Clinical review: Status epilepticus

Sarice Bassin et al., Critical Care (2002)

What’s inside

This clinical review provides a comprehensive overview of status epilepticus, detailing its pathophysiology, diagnostic approach, and management strategies in the ICU setting. It covers initial treatment, escalation protocols, and considerations for refractory cases.

Why it’s relevant

Status epilepticus is a critical emergency that can lead to irreversible neurological damage. This review is valuable for ICU professionals, offering practical guidance for timely and effective intervention in critically ill patients.

Key focus

  • Definition and classification of status epilepticus
  • Initial management, including airway support and first-line anticonvulsants
  • Escalation strategies for refractory status epilepticus
  • Role of EEG monitoring in diagnosis and treatment
  • Post-seizure care and preventing recurrence

Takeaway

This review provides ICU professionals with essential knowledge on managing status epilepticus, focusing on prompt diagnosis, treatment escalation, and monitoring to minimize long-term damage and improve patient outcomes.

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