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• Vol.41 No.12
• CLINICA NEUROL, 41: 1097−1099, 2001
• Vol.41 No.12 contents

The 42nd Annual Meeting of the Japanese Society of Neurology

Symposium IV-4: Treatments of intractable epilepsies
Treatment of status epilepticus

Sadatoshi Tsuji, M. D. and Naoki Akamatsu, M. D.

Department of Neurology, University of Occupational and Environmental Health, School of Medicine

Status epilepticus (SE) is a condition requiring emergency care. There are convulsive SE, non-convulsive SE including complex partial status and absence status, non-convulsive electric SE and pseudostatus epilepticus, although convulsive SE is the most common. Diagnosis of status epilepticus of complex partial seizures (CPS) and absence seizures was significantly delayed because delays in seeking medical attention were common. The seizures were generalized convulsive SE in 84% and CPS status in 16%, and the overall mortality rate was 15% in 41 SE patients of our study.
EEG monitoring is important to make or exclude the diagnosis of SE.
Diazepam is the first choice medication and effective in the management of SE, and lately, lorazepam, midazolam, propofol and pentobarbital etc as emergency therapy. Phenytoin is also considered first-line agent in the emergency management of SE.
Repetitive transcranial magnetic stimulation (rTMS) led to a prolonged latency for seizure induction after an intraperitoneal injection of pentylenetetrazol (PTZ) and effectively prevented the development of status epilepticus of PTZ-induced convulsions in the rats. Our data suggest that rTMS has suppressive effects on the neuronal excitability in rats. These effects are anticonvulsive and suggest the possibility of therapeutic use of rTMS in the patients with refractory seizures.

(CLINICA NEUROL, 41: 1097−1099, 2001)
key words: convulsive status epilepticus, non-convulsive status epilepticus, first choice medication, treatment with transcranial magnetic stimulation, animal model of status epilepticus

(Received: 12-May-01)