Status epilepticus and epilepsy: when seizure becomes uncontrolled
Experience in Indonesia
Department of Child Health
Faculty of Medicine University of Indonesia CiptoMangunkusumo Hospital
Status epilepticus is defined as recurrent seizures over a period of >30 minutes without complete recovery of consciousness between attacks or continuous seizure activity lasting >30 minutes. In 2016, the Indonesian Child Neurology Working Group has established a Consensus for the Management of Status Epilepticus which has agreed on several management points. In emergency care, pending the installation of an intravenous line, rectal diazepam can be repeated once. If the seizure continues, administration of 20 mg/kg intravenous phenytoin is indicated. If the seizure continues 20 minutes after administration of phenytoin, 20 mg/kg IV phenobarbital should be given. The order of administration of phenytoin and phenobarbital is interchangeable. If seizure continues, intravenous midazolam infusion should be given, along with maintenance phenytoin and phenobarbital. Midazolam infusion may be tapered following 24 hours of seizure freedom. Patient was presenting with intractable epilepsyby 1st line and 2nd line the Antiepileptic Drugs (AEDs). If seizures still going on we tried to give ketogenic diet. We have coordination with Pediatric Nutrition and Metabolic Consultant. Ketogenic diet with full cream formula Ketocal. If seizures stop more than 6 months, AED will be tappered off.
Keywords: children, status epilepticus,
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