Status epilepticus complex partial

Status epilepticus Among the patients treated with tiagabine across all epilepsy studies (controlled and uncontrolled), 5% had some form of status epilepticus. Of the 5%, 57% of patients experienced complex partial status epilepticus. A critical risk factor for status epilepticus was the presence of the condition history 33% of patients with a history of status epilepticus had recurrence during tiagabine treatment. 

Jacobs DA, Fung KM, Cook NM, Schalepfer WW, Goldberg HI, Stecker MM. Complex partial status epilepticus associated with anti-Hu paraneoplastic syndrome. J Neurol Sci 2003 213(1 2) 77 82. 

Therapeutic uses Phenytoin is highly effective for all partial seizures (simple and complex), for tonic-clonic seizures, and in the treatment of status epilepticus caused by recurrent tonic-clonic seizures (Figure 15.3). Phenytoin is not effective for absence seizures, which often may worsen if such a patient is treated with this drug. 

A1 Tahan A. Paradoxic response to diazepam in complex partial status epilepticus. Arch Med Res 2000 31(l) 101-4. 

Brouns R, Van Paesschen W. Recurrent complex partial status epilepticus associated with tiagabine rechaUenge. Acta Neurol Belg 2002 102(l) 19-20. 

Trinka E, Moroder T, Nagler M, Staffen W, Loscher W, Ladurner G. Chnical and EEG findings in complex partial status epilepticus with tiagabine. Seizure 1999 8(l) 41-4. 

Doses of vigabatrin up to 10 g have been taken without serious effects. Toxic manifestations include vertigo, tremor, sedation, coma, myoclonic jerks, and psychosis. Gastric lavage within 1-2 hours is recommended after doses in excess of 12 g in adults and 2 g in children (SEDA-22,85). The development of discontinuous partial complex status epilepticus in a patient with partial epilepsy who had taken a 20 g overdose 6 days earher was considered to be a possible effect of withdrawal (SEDA-22, 85). 

Phenytoin is indicated for initial monotherapy or adjunct treatment of complex partial or tonic-clonic seizures, convulsive status epilepticus, and prophylaxis. It often is selected for initial monotherapy because of its high efficacy and relatively low incidence of side effects (29). Phenytoin is not used in the treatment of absence seizures, because it may increase their frequency of occurrence (30,31). Phenytoin binds to and stabilizes the inactivated state of sodium channels, thus producing a use-dependent blockade of repetitive firing and inhibition of the spread of seizure activity to adjacent cortical areas. 

Phenytoin is used orally for the prevention of generalized (grand mal) and partial complex seizures. Intravenous phenytoin is used to treat status epilepticus and occasionally as an antiarrhythmic agent. Oral formulations include suspensions, capsules, and tablet preparations. The brand Dilantin Kapseals exhibits delayed absorption characteristics not usually shared by generic products. 

Valproic acid (Depakene or Depakote [divalproex sodium]) is a structurally unique anticonvulsant. It is used for the treatment of absence seizures, partial complex, and generalized seizure disorders and is a secondary agent for refractory status epilepticus. It is also commonly used for the prophylaxis and treatment of acute manic episodes and other affective disorders, migraine prophylaxis, and chronic pain syndromes. 

Shneker BF, Baylin PD, Nakhia ME. Linezolid inducing complex partial status epilepticus in a patient with epilepsy. Neurology 2009 72(4) 378-9. 

Corda D, Rosati G, Deiana GA, Sechi G. Erratic complex partial status epilepticus as a presenting feature of MELAS. (2006). Epilepsy Behavior 8 655-658. 

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