Estado de mal epiléptico em adultos: Revisão e proposta de protocolo

Abstract

Introduction: Status epilepticus (SE) is a serious condition with an incidence of approximately 90,000 cases per year in Brazil. Unfortunately, there is still no consensus on several of its aspects, from its definition to its treatment. Objectives and Methods: This review brought together the most significant data in the literature between 1960 and 2011, in Portuguese, in English and one article in Spanish, searched in PubMed CAPES journals, ILAE, AAN. The term status epilepticus was combined with definition, EEG, classification, causes, treatment, guidelines, monitoring (EEG), controlled clinical trial, randomized controlled trial, multicentre study, meta-analysis, cross over study. Results: The definition and classification of SE are varied, but we tried to objectify them, as well as its treatment in an attempt to develop an updated protocol for adult patients. Few randomized trials were found, and most of them are about pre-hospital treatment and initial phase of SE. Discussion: Little has been studied properly about the refractory phase, and this part of our protocol is based in other review articles, case reports and expert opinion. Further studies on this phase of treatment, and consensus on the definition and classification are necessary to standardize the treatment of this condition.