Etiological assessment of status epilepticus - 08/06/20
pages | 19 |
Iconographies | 5 |
Vidéos | 0 |
Autres | 0 |
Abstract |
Status epilepticus (SE) is a potentially serious condition that can affect vital and functional prognosis and requires urgent treatment. Etiology is a determining factor in the patient's functional outcome and in almost half of all cases justifies specific treatment to stop progression. Therefore, identifying and addressing the cause of SE is a key priority in SE management. However, the etiology can be difficult to identify among acute and remote causes, which can also be multiple and interrelated. The most common etiologies are the discontinuation of antiepileptic medication in patients with a prior history of epilepsy, and acute brain aggression in cases of new onset SE (cerebrovascular pathologies are the most common). The list of remaining possible etiologies includes heterogeneous pathological contexts. Refractory SE and especially New-Onset Refractory Status Epilepticus (NORSE) lead to an extension of the etiological assessment in the search for encephalitis of autoimmune or infectious origin in adults and in children, as well as a genetic pathology in children in particular. This is an overview of current knowledge of SE etiologies and a pragmatic approach for carrying out an etiological assessment based on the following steps: – Which etiological orientation is identified according to the field and clinical presentation?; – Which etiologies to look for in an inaugural SE?; – Which first-line assessment should be carried out? The place of the biological, EEG and imaging assessment is discussed; – Which etiologies to look for in case of refractory SE?
Le texte complet de cet article est disponible en PDF.Keywords : Seizure, NORSE (New onset refractory status epilepticus), Autoimmune encephalitis, FIRES (Febrile infection epilepsy-related syndrome), Nonconvulsive
Plan
Vol 176 - N° 6
P. 408-426 - juin 2020 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement.
Bienvenue sur EM-consulte, la référence des professionnels de santé.
L’achat d’article à l’unité est indisponible à l’heure actuelle.
Déjà abonné à cette revue ?