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Vol. 24. Núm. 9.
Páginas 405-412 (Diciembre 2000)
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Vol. 24. Núm. 9.
Páginas 405-412 (Diciembre 2000)
Acceso a texto completo
Estado epiléptico
Status Epilepticus
Visitas
30259
O. Barakat1, M.J. Fernández Pérez, J.A. Corrales Cruz, F.J. González Fernández, G. Izquierdo Ayuso, J. Fajardo Gálvez
Servicio de Medicina Intensiva. Hospital Universitario Virgen Macarena. Sevilla
Este artículo ha recibido
Información del artículo
Objetivos

El estado epiléptico es una emergencia médica que precisa una actuación rápida y sistematizada. La asistencia al paciente epiléptico por el intensivista no debe encaminarse únicamente a controlar la crisis, sino a disminuir sus consecuencias y evitar su recurrencia. En este artículo se revisan la fisiopatología, clasificación, causas, diagnóstico, tratamiento y pronóstico del estado epiléptico.

Fuente de datos

La recopilación de la información necesaria para realizar esta revisión, se ha realizado a partir del resultado de una búsqueda bibliográfica exhaustiva y actualizada en MEDLINE.

Resultados y conclusiones

El control precoz del estado epiléptico se correlaciona directamente con su buen pronóstico. Tener un protocolo de actuación definido es fundamental para conseguir este objetivo. Tras el cese de la actividad convulsiva, es imprescindible la monitorización de la actividad cerebral del paciente, pues en un número considerable de pacientes persiste un estado epiléptico “oculto” no convulsivo, que compromete y condiciona el pronóstico del enfermo. En más de la mitad de los casos existe una causa orgánica demostrable del estado epiléptico. El pronóstico de estos pacientes es peor que los que debutan por una causa no demostrable. La búsqueda de esta causa es fundamental para plantear soluciones definitivas y evitar la recurrencia de la crisis.

Palabras clave:
estado epiléptico
fisiopatología
clasificación
causa
diagnóstico
tratamiento
pronóstico
Aim

Status epilepticus is a medical emergency requiring rapid and systematic action. Intensivists should aim not only to manage the crisis but also to lessen its consequences and avoid recurrence. In this article, the physiopathology, classification, causes, diagnosis, treatment and prognosis of status epilepticus are reviewed.

Data source

An exhaustive and up-to-date MEDLINE search was performed to collect the information necessary for this review.

Results and conclusions

The early treatment of status epilecticus is directly correlated with favorable prognosis. A defined protocol of action is essential to achieve this. Monitoring the patient’s brain activity once convulsions have ceased is essential since “occult” non-convulsive status epilepticus persists in a significant number of patients, wich compromises and determines prognosis. Demonstrable organic cause of status epilepticus can be found in more than half of cases. The prognosis of these patients is worse than that of patient who first present with no demonstrable cause. The search for this cause is fundamental for providing definitive solutions and avoiding recurrence of the crisis.

Key words:
status epilepticus
physiopathology
classification
cause
diagnosis
treatment
prognosis
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Copyright © 2000. Sociedad Española de Medicina Intensiva, Critica y Unidades Coronarias (SEMICYUC) and Elsevier España, S.L.
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