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2016 ; 5
(5
): ä Nephropedia Template TP
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Managing Status Epilepticus in the Older Adult
#MMPMID27187485
Legriel S
; Brophy GM
J Clin Med
2016[May]; 5
(5
): ä PMID27187485
show ga
The aim of this systematic review was to describe particularities in
epidemiology, outcome, and management modalities in the older adult population
with status epilepticus. There is a higher incidence of status epilepticus in the
older adult population, and it commonly has a nonconvulsive presentation.
Diagnosis in this population may be difficult and requires an unrestricted use of
EEG. Short and long term associated-mortality are high, and age over 60 years is
an independent factor associated with poor outcome. Stroke (acute or remote
symptomatic), miscellaneous metabolic causes, dementia, infections hypoxemia, and
brain injury are among the main causes of status epilepticus occurrence in this
age category. The use of anticonvulsive agents can be problematic as well. Thus,
it is important to take into account the specific aspects related to the
pharmacokinetic and pharmacodynamic changes in older critically-ill adults.
Beyond these precautions, the management may be identical to that of the younger
adult, including prompt initiation of symptomatic and anticonvulsant therapies,
and a broad and thorough etiological investigation. Such management strategies
may improve the vital and functional prognosis of these patients, while
maintaining a high overall quality of care.
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