Episode 67:Status Epilepticus
In collaboration with
A PODCAST LECTURE BY Brandon Foreman
20/12/22
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SPEAKER Bio
brandon Foreman
Dr. Foreman is an expert in brain monitoring in the ICU using EEG to detect seizures and spreading depolarizations after brain injury. Dr. Foreman is a member of multi-center collaborative efforts such as the Critical Care EEG Monitoring Research Consortium (CCEMRC) and the Co-Operative Spreading Brain Injury Depolarizations consortium (COSBID). He co-founded the translational Collaborative for Research on Acute Neurological Injuries (CRANI), a team science award-winning organization at UC. He organizes the U01-funded TRACK-TBI ICU Working Group and has received NIH/NINDS funding to examine the role of intracranial pressure on cognitive outcome and is a co-investigator for the DOD-funded INDICT study of ECoG-guided management of patients with severe TBI. Dr. Foreman’s research focuses cortical physiology – pressure, flow, metabolism, and function – and how this can be integrated at the bedside in order to provide precision critical care to improve cognitive outcome after brain injury.
LECTURE SUMMARY
Status epilepticus is a life-threatening emergency. However, there are different forms of status epilepticus: focal to bilateral tonic-clonic status epilepticus and focal status epilepticus. Focal status epilepticus may have prominent motor symptoms, often with impaired awareness, or may be nonconvulsive. The implications of this are important: the treatment of focal to bilateral tonic-clonic seizures requires immediate action. Evidence for first-line therapy is clear that benzodiazepines should be administered in adequate doses we will review those studies. New evidence for second-line treatment has emerged, as well. In those with focal status epilepticus, urgent treatment is still indicated but the approach is more nuanced and less likely to require an escalation to third-line agents, such as anesthetics. We review these concepts and provide some guidance for clinical practice.
LEARNING OBJECTIVES
Upon completion of this activity, you should be able to:
Define focal to bilateral tonic-clonic status epilepticus vs focal status epilepticus
Recognize status epilepticus as a medical emergency
Describe current treatment options for status epilepticus