28 Questions
What is refractory status epilepticus?
SE that has failed to respond to therapy with at least two medications
What is superrefractory status epilepticus?
SE that fails to resolve within 24 hours despite therapy
What is the trend regarding the minimum duration of refractory status epilepticus currently?
There is no specific minimum duration assigned currently
How is new-onset refractory status epilepticus (NORSE) different?
It is a distinct entity caused by prior epilepsy
In what situations should refractory status epilepticus be considered?
Especially in an unresponsive or encephalopathic child
What is another name for Devastating epileptic encephalopathy in schoolage children?
Seizure-induced refractory epileptic encephalopathy in adolescents
What is a characteristic feature of hemiconvulsion–hemiplegia–epilepsy syndrome?
Prolonged febrile status epilepticus
What is the suspected etiology of Devastating epileptic encephalopathy in schoolage children and FIRES?
Autoimmune and para-infectious
Which factor accounts for the highest percentage as a cause of Devastating epileptic encephalopathy in schoolage children?
Medication change
How is the ketogenic diet typically used in the treatment of Devastating epileptic encephalopathy in schoolage children?
As a potentially responsive intervention
Which class of drugs can cause seizures, as mentioned in the text?
Antibiotics
Which of the following is NOT mentioned as a drug that can cause seizures in the text?
Morphine
What diagnostic assessment is NOT recommended in the text for patients with seizures?
Ultrasound of the liver
What are the potential respiratory complications mentioned in the text related to seizures?
Hypoxia and hypercarbia
What is a rare complication associated with seizures according to the text?
Neurogenic pulmonary edema
What should be considered in patients with prolonged seizures according to the text?
Metabolic and genetic testing
What is the time frame recommended by the Neurocritical Care Society Guidelines for achieving definitive seizure control after seizure onset?
60 minutes
When may a decision be made to proceed to continuous infusion and intubation in a patient with ongoing convulsive seizures?
After 30-60 minutes of convulsive seizures
What is the goal of using an intravenous bolus followed by continuous infusion of medications like midazolam, propofol, pentobarbital, or thiopental in refractory status epilepticus treatment?
To achieve complete flattening of the EEG
When might a patient with status epilepticus need to be intubated?
After the second or third medication is given
Why is EEG considered the method of choice to follow patients with status epilepticus?
To stop electrographic seizure activity
What is the ideal time frame for receiving urgent therapies in status epilepticus management to reduce the chances of sequelae?
< 30 minutes
What is a potential complication associated with patients receiving pentobarbital coma therapy?
Requirement for multiple vasopressors to maintain blood pressure
Which complication limits the use of propofol in the pediatric population?
Rhabdomyolysis
What is a common characteristic of patients with superrefractory status epilepticus (SRSE)?
Lack of response to 24 hours of general anesthesia
What is a potential complication of using ketamine infusion to treat superrefractory status epilepticus?
Hemodynamic instability
How do NMDA receptors relate to the treatment of status epilepticus?
Increase in NMDA receptor upregulation is associated with ketamine use
What is a key consideration in the treatment of superrefractory status epilepticus?
Initiation of polytherapy with other AEDs
Test your knowledge on drugs and medical conditions that can lead to seizures. From antibiotics to psychopharmaceuticals, learn about the different substances and scenarios that may trigger seizures.
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