Current Treatment Proposal for Children and Adolescents in Status Epilepticus in Cuba
Keywords:
status epilepticus, little boy, teenagers, treatment, emergencyAbstract
Introduction: The adequate treatment of status epilepticus depends on many factors; among these, the availability of medicines, the experience of who indicates it, who, and where it is applied.
Objective: To propose a treatment protocol for children and adolescents in status epilepticus, not including status without motor manifestations or in newborns, which is currently feasible in Cuba.
Acquisition of the evidence: The search was carried out in the available databases in Google and PubMed/Medline. Articles in English and Spanish published in the last ten years and others referenced in the reviewed literature were included. Some related to care for adults and children were included due to their importance, but they clarify the position of the authors in both groups.
Results: They are based on the published reports and the experience acquired in the Pediatric Neurology Service, in the Emergency Department and in the Pediatric Intensive Care Unit at Juan Manuel Márquez Pediatric Teaching Hospital, since 1990; to try to reduce the time of epileptic activity and thus reduce the risk of mortality, morbidity and improve the quality of life of patients. The use of benzodiazepines was the first recommended treatment option, followed by a second dose, or by IV phenytoin, or the combination, in case of non-control.
Conclusions: The use of benzodiazepines (diazepam or midazolam) and IV phenytoin are the drugs of choice in early and established status epilepticus. Next, the administration of other drugs is less well defined. Rectal sodium valproate and enteral topiramate, in status epilepticus, can be considered in Cuba, although they are not included among the most internationally recommended drugs.
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