Second-line status epilepticus treatment approaches ‘need more research’

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A new study has highlighted the need for additional research into second-line treatment options for acute generalised convulsive status epilepticus (GCSE).

Researchers from the University of Virginia have examined data from 177 GCSE cases to determine the current state of practice of treatment for acute GCSE and trends pertaining to responsiveness to therapy.

Results published in the journal Epilepsy & Behavior underlined the fact that approximately half of GCSE patients respond to first-line therapy, with around two-thirds responding to second-line treatment and three-quarters benefiting from third-line therapies.

However, beyond the use of benzodiazepines for first-line treatment – which was the case for all but one of the 177 patients assessed – there appears to be little clinical evidence available to guide therapy strategies.

In particular, it was noted that phenytoin – the most prescribed second-line treatment – was actually the least effective of all those assessed, underlining the strong need for a large randomised controlled trial of second-line therapies.

GCSE is the most common form of status epilepticus and should be treated as a medical emergency.

Posted by Bob Jones

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