By Simon Shorvon
This ebook offers an intensive reappraisal of prestige Epilepticus, the severest expression of epilepsy. within the mild of recent examine it conscientiously examines present therapy, seriously difficult latest tenets. A scheme of type is proposed established now not exclusively on seizure kind but in addition on age, pathophysiological mechanisms and scientific positive aspects, contemplating the place attainable the medical points of prestige within the context in their medical foundation, no matter if this can be epidemiology, neurophysiology, neuropathology or neuropharmacology. a pragmatic bias is maintained all through, in keeping with scientific adventure, with maximum area dedicated to remedy, together with experiences of efficacy and toxicity of person medicinal drugs and valuable use of tables to obviously summarize key info. it is a uniquely finished overview of the big quantity of released literature during this box and should act as a useful reference paintings and functional advisor for quite a lot of training clinicians, from neurologists, psychiatrists and paediatricians all over to these concerned essentially in emergency medication.
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Additional info for Status Epilepticus: Its Clinical Features and Treatment in Children and Adults
The basis of this figure is unclear and unreferenced. 3 are computations based on these figures, for the total US population and for the UK population (assuming an age structure approximately similar to that in the USA) and a similar general population of 1 000 000 persons. As the frequency of status is strongly age dependent, total numbers would be expected to be higher in developing countries where a greater proportion of cases are in the younger age groups, and also where more symptomatic epilepsy occurs.
No distinction is made between recurrent or prolonged seizures, nor is the activity required to be enduring or unvarying. The diversity of clinical features of status is also recognised, as is the highly variable patho-anatomical and aetiological basis. As will become evident, such a definition allows a liberal interpretation of what can be counted as status, deliberately so, in an attempt to encourage thought about the principles of status, unemcumbered with arbitrarily restrictive criteria. I believe that the definition conforms to the spirit of status, without being overinclusive or overexclusive, although there exist (as is usual in epilepsy) a range of boundary conditions where the distinction between epilepsy and either functional (psychiatric) or organic (encephalopathic) symptoms is difficult to make.
Clearly, all such figures are approximations only, and are based on what are highly unreliable data. On the whole, as the bias is towards underreporting for all the reasons discussed above, these statistics should be considered as minimum estimates; the true figure may be much higher. The statistics are, furthermore, concerned only with tonic-clonic status, and other forms are very common. The following have been ignored: 5. Typical absence status: a history of absence status is said to occur in 5-10% of all patients with generalised absence (petit mal) seizures.