Improving Emergency Medicine Patient Care		 For Questions Or To Order, Call
800-249-5770
Mon-Fri 8am-5pm EST
View Full Site
Home Browse Articles CME Tests Login
Subscribe Visit Store View Cart

Home > Browse Emergency Issues

<< Seizures and Status Epilepticus: Diagnosis and Management in the Emergency Department

References

Evidence-based medicine requires a critical appraisal of the literature based upon study methodology and number of subjects. Not all references are equally robust. The findings of a large, prospective, randomized, and blinded trial should carry more weight than a case report.

To help the reader judge the strength of each reference, pertinent information about the study, such
as the type of study and the number of patients in the study, will be included in bold type following the
reference, where available.

  1. Working Group on Status Epilepticus: Treatment of convulsive status epilepticus: Recommendations of the Epilepsy Foundations of America’s Working Group on Status Epilepticus. JAMA 1993;270:854-9.
  2. 2. Lowenstein DH, Bleck, T, Macdonald RL. It’s time to revise the definition of status epilepticus. Epilepsia, 1999; 40:120-122. 
  3. 3. Alldredge BK, Gelb AM, Isaacs M ea: A comparison of lorazepam, diazepam, and placebo for the treatment of out-ofhospital status epilepticus. N Engl J Med 2001;345:631-637. 
  4. 4. Treiman DM, Meyers PD, Walton NY, et al. for the Veterans Affairs Status Epilepticus Cooperative Study Group. A comparison of four treatments for generalized convulsive status epilepticus. NEJM 1998;339:792-8.
  5. 5. Shinnar S, Berg AT, Moshe SL, Shinnar R. How long do newonset seizures in children last? Ann Neurol 2001;49:659-664. 
  6. 6. Krumholz A, Grufferman S, Orr S, Stern B, Seizures and seizure care in an emergency department, Epilepsia 1989; 30:175-181. Retrospective review over 6 months. 200 cases / 29,000 ED visits 
  7. 7. Huff JS, Morris DL, Kothari RU et al., Emergency department management of patients with seizures: a multicenter study. Medical Interface. Acad Emerg Med 8 (2001), pp. 622–628. 
  8. 8. Hauser WA and Kurland LT, The epidemiology of epilepsy in Rochester, Minnesota, 1935 through 1967. Epilepsia 16 (1975), pp. 1–66 
  9. 9. McCaig, LF and Burt CW, “National Hospital Ambulatory Medical Care Survey: 2001 Emergency Department Summary: 2001,”Advance Data From Vital and Health Statistics; No. 335,: National Center for Health Statistics, Hyattsville, Md. (2003); U.S. General Accounting Office, Hospital Emergency Departments: Crowded Conditions Vary Among Hospitals and Communities (GAO-03-460), Washington, D.C. (March 2003). 
  10. 10. DeLorenzo RJ, Towne AR, Pellock JM et al., Status epilepticus in children, adults, and the elderly. Epilepsia 33 Suppl 4 (1992), pp. S15–25. 
  11. 11. Coeytauz A, Jallon P, Galobardes B, et al. Incidence of status epilepticus in French-speaking Switzerland (EPISTAR). Neurology 2000;55:693-7. 
  12. 12. DeLorenzo RJ, Hauser WA, Towne AR, et al. A prospective, population based epidemiologic study of status epilepticus in Richmond, Virginia. Neurology 1996;46:1029-35 
  13. 13. Semah F, Picot M, Adam C, et al. Is the underlying cause of epilepsy a major prognostic factor for recurrence. Neurology 1998; 51: 1256-1262. Cross sectional, observational hospital based study. 2200 patients 
  14. 14. Hauser W, The natural history of drug resistant epilepsy: epidemiologic considerations. Epilespia 1992; suppl 5:25-28. Review 
  15. 15. Hauser W, Rich S, Annegers J, Anderson E. Seizure recurrence after a first unprovoked seizure: An extended followup. Neurology 1990; 40:1163-1170. Prospective cohort. 208 patients 
  16. 16. Wu YW, Shek DW, Garcia PA, Zhao S, Johnston SC. Incidence and mortality of generalized convulsive status epilepticus in California. Neurology 2002;58:1070-1-76. 
  17. 17. Delorenzo R, Lacrix J, Gauthier D. Admissions to a pediatric intensive care unit for status epilepticus: A 10-year experience. Crit Care Med 1994; 22:827-832. Retrospective descriptive study. 147 patients 
  18. 18. Knake S, Rosenow, F, Vescovi M, et al. Incidence if Status Epilepticus in Adults in Germany: A Prospective, Population- Based Study, Epilepsia 2001;42:714-8. 
  19. 19. Vignatelli L, Caterina T, D’Alessandro R, Incidence and Short-term Prognosis of Status Epilepticus in Adults in Bologna, Italy, Epilepsia 2003;44:964-68.
  20. 20. Hesdorffer DC, Logroscino G, Cascino G, Annegers JF, Hauser WA. Incidence of status epilepticus in Rochester, Minnesota, 1965–1984. Neurology 1998; 50: 735–741. 
  21. 21. Logroscino G, Hesdorffer DC, Cascino GD, et al. Long-term mortality after a first episode of status epilepticus. Neurology, 2002;58:537-41. 
  22. 22. Lowenstein DH, Aldredge BK, Status Epilepticus, New Engl J Med 1998;338:970-6.
  23. 23. Jagoda A, Riggio S, Refractory status epilepticus in adults. Ann Emerg Med, 1993;22:1337-48. 
  24. 24. Walton NY, Treiman DM. Response of status epilepticus induced by lithium and pilocarpine to treatment with diazepam. Exo Neurol 7998;101:267-75.
  25. 25. Lowenstein DH, Alldredge BK. Status epilepticus in an urban hospital in the 1980s. Neurology 1993;43:483-8. 
  26. 26. Wachtel T, Steele G, Day J. Natural history of fever following seizure. Arch Intern Med. 1987; 147:1153-1155. Retrospective.93 patients. 
  27. 27. Aminoff M, Simon R. Status epilepticus: causes, clinical features and consequences in 98 patients. Am J Med 1980; 69:657- 666.
  28. 28. Orringer C, Eustace J, Wunsch C, et al, Natural history of lactic acidosis after grand-mal seizures. New Engl J Med 1977; 297:796-799. Prospective convenience sample. 8 patients )
  29. Dodrill C, Wilensky A. Intellectual impairment as an outcome of status epilepticus. Neurology 1990; 40 (suppl 2): 23- 27. Prospective study. 143 adults
  30. Lothman E. The biochemical basis and pathophysiology of status epilepticus. Neurology 1990; 40 (suppl 2):13-23. Review)
  31. Lin J. Convulsive syncope in blood donors. Ann Neurol 1982; 11:525-528. Prospective cohort. 84 patients 
  32. Linzer M, Grubb B, Simon H, Ramakrishnan L, Bromfield E, Estes N. Cardiovascular causes of loss of consciousness in patients with presumed epilepsy: a cause of increased sudden death rate in people with epilepsy. Am J Med 1994; 96:146- 154. Case series. 12 patients
  33. Bell MR. Kozak RJ. Seizures and the long-QT syndrome. Annals of Emergency Medicine. 28:556-60, 1996
  34. Haines S. Decerebrate posturing misinterpreted as seizure activity, Am J Emerg Med 1988; 6:173-177. Case series, 4 patients
  35. McCrory PR. Berkovic SF. Video analysis of acute motor and convulsive manifestations in sport-related concussion. Neurology. 54:1488-91, 2000. Retrospective analysis of a prospective cohort. 234 cases.
  36. Marks D, Ehrenberg B. Migraine related seizures in adults with epilepsy with EEG correlation. Neurology 1993; 43:2476- 2483. Prospective cohort. 395 patients
  37. Dieckmann R. Rectal diazepam for prehospital pediatric status epilepticus. Ann Emerg Med 1994; 23:216-224. Retrospective review. 31 patients
  38. Alldredge B, Wall D, Ferriero D. Effect of prehospital treatment on the outcome of status epilepticus in children. Pediatr Neurol 1995; 12:213-216. Retrospective review. 45 patients,
  39. McArthur CL 3rd. Rooke CT. Are spinal precautions necessary in all seizure patients?. Am J Emerg Med 1995; 13:512-3. Retrospective. 1656 patients
  40. Abarbanell N. Prehospital seizure management: Triage criteria for the advanced life support rescue team. Am J Emerg Med 1993; 11:210-214. Retrospective. 230 patients.
  41. Shandera WX. White AC Jr. Chen JC. Diaz P. Armstrong R. Neurocysticercosis in Houston, Texas. A report of 112 cases. Medicine. 73:37-52, 1994. Case series
  42. Kanu I, Anyanwu EC, Nwachukwu NC, Ehiri JE, Merrick J. Clinical microbiological aspects of epileptic seizures in the tropical countries with specific focus on Nigeria. Scientific World Journal. 2005 May 13;5:401-9.
  43. Pear B. Bilateral posterior fracture dislocation of the shoulder: An uncommon complication of a convulsive seizure. New Engl J Med 1970; 283:135-136. Case report.
  44. Finelli P, Cardi J. Seizures as a cause of fracture. Neurology 1989; 39:858-860. Retrospective. 2800 patients. McCullen G, Brown C. Seizure-induced thoracic burst fractures: A case report. Spine 1994; 19:77-79. Case report and review
  45. Eisner RF, Turnbull TL, Howes DS, Gold IW. Efficacy of a “standard” seizure workup in the emergency department. Ann Emerg Med. 1986; 15:33-39.
  46. Powers RD. Serum chemistry abnormalities in adult patients with seizures. Ann Emerg Med. 1985;14:416-420. Retrospective review. 181 patients
  47. Turnbull TL, Vandenhoek TL, Howes DS, Eisner RF. Utility of laboratory studies in the emergency department patient with a new-onset seizure. Ann Emerg Med. 1990;19:373-7.
  48. American College of Emergency Physicians. Clinical Policy: Critical Issues in the evaluation and managementof adult patients presenting to the emergency department with seizures. Ann Emerg Med. 2004;43(5):605-625.
  49. Sempere AP, Villaverde FJ, Martinez-Menendez B, et al. First seizure in adults: a prospective study from the emergency department. Acta Neurol Scand. 1992;86:134-8.
  50. Tardy B, Lafond P, Convers P. Adult first generalized seizure: etiology, biological tests, EEG, CT scan, in an ED. Amer J Emerg Med. 1995; 13:1-5. Retrospective review. 247 patients.
  51. Knight AH, Rhind EG. Epilepsy and pregnancy: a study of153 pregnancies in 59 patients. Epilepsia. 1975;16:99-110.
  52. American Academy of Neurology. Practice parameter: Evaluating a first nonfebrile seizure in children. Neurol. 2000;55:616-623.
  53. Olson KR. Seizures associated with poisoning and drug overdose. Amer J Emerg Med. 1994;12:392-395.
  54. Dhuna A, Pascual-Leone A, Langendorf F, et al. Epileptogenic properties of cocaine in humans. Neurotoxicology. 1991;12:621-626.
  55. Pesola GR. Westfal RE. New-onset generalized seizures in patients with AIDS presenting to an emergency department. Acad Emerg Med. 1998;5:905-911.
  56. Ng S, Hauser W, Brust J, et al. Alcohol consumption and withdrawal in new-onset seizures. N Engl J Med. 1988;319:666-673.
  57. Libman MD. Potvin L. Coupal L. Grover SA. Seizure vs. syncope: Measuring serum creatine kinase in the emergency department. J Gen Int Med 1991; 6:408-12, 1991
  58. Wyllie E, Lueders H, Pippenger C, VanLente F. Postictal serum creatine kinase in the diagnosis of seizure disorders. Arch Neurol 1985; 42:123-126. 189 events
  59. Boehnert M, Lovejoy F. Value of the QRS duration versus the serum drug level in predicting seizures and ventricular arrhythmias after an acute overdose of tricyclic antidepressants. New Engl J Med 1985; 313:474-479. Prospective cohort. 49 patients
  60. Wolfe T, Caravan E, Rollins D. Terminal 40-ms frontal plane QRS axis as a marker for tricyclic antidepressant overdose. Ann Emerg Med 1989; 18:348-351. Retrospective cohort. 48 patients
  61. Henneman P, DeRoos F, Lewis R. Determining the need for admission in patients with new-onset seizures. Ann Emerg Med 1994; 24:1108-1114. Retrospective. 294 patients
  62. American College of Emergency Physicians, American Academy of Neurology, American Association of Neurological Surgeons, American Society of Neuroradiology. Practice Parameter: Neuro-imaging in the emergency patient presenting with seizure (Summary Statement). Ann Emerg Med 1996; 27:114-118. Evidence based practice guideline).
  63. Lee ST, Lui TN. Early seizures after mild closed head injury. J Neurosurg. 1992;76:435-439.
  64. Green SM, Rothrock SG, Clem KJ, et al. Can seizures be the sole manifestation of meningitis in febrile children? Pediatrics. 1993;92:527-34.
  65. Rosenberg NM. Seizures associated with meningitis. Pediatr Emerg Care. 1992;8:67-9.
  66. Rider L, Thapa P, Del Beccaro M, et al. Cerebrospinal fluid analysis in children with seizures. Ped Emerg Care 1995; 11:226-229. Prospective convenience sample. 212 patients
  67. Kaplan PW. Nonconvulsive status epilepticus in the emergency room. Epilepsia 37 (1996), pp. 643–650.
  68. Guberman A, Cantu-Reyna G, Stuss D et al., Nonconvulsive generalized status epilepticus: clinical features, neuropsychological testing, and long-term follow-up. Neurology 36 (1986), pp. 1284–1291.
  69. Towne AR, Waterhouse EJ, Boggs JG, Garnett LK, Brown AJ, Smith JR Jr, DeLorenzo RJ. Prevalence of nonconvuslive status epilepticus in comatose patients. Neurology 2000;54:340-345.
  70. DeLorenzo RJ, Waterhouse EJ, Towne AR, Boggs JG, Ko D, DeLorenzo GA, Brown A, Garnett L. Persistent nonconvulsive status epilepticus after the control of generalized convulsive status epilepticus. Epilepsia 1998;39:833-840.
  71. Young GB, Jordan KG and Doig GS, An assessment of nonconvulsive seizures in the intensive care unit using continuous EEG monitoring: an investigation of variables associated with mortality. Neurology 47 (1996), pp. 83–89.
  72. Annegers JF, Shirts SB, Hauser WA, Kurland LT. Risk of recurrence after an initial unprovoked seizure. Epilepsia. 1986; 27:43-50.
  73. Berg AT, Shinnar S. The risk of seizure recurrence following a first unprovoked seizure: a quantitative review. Neurology. 1991;41:965-972.
  74. First Seizure Trial Group (FIR.S.T. Group). Randomized clinical trial on the efficacy of antiepileptic drugs in reducing the risk of relapse after a first unprovoked tonic-clonic seizure. Neurology. 1993;43:478-483.
  75. Temkin NR, Dikman SS, Wilensky AJ, et al. A randomized, double blind study of phenytoin for the prevention of posttraumatic seizures. New Engl J Med. 1990; 323:497-502.
  76. French J. The long-term therapeutic management of epilepsy. Ann Int Med 1994; 120:411-422. Review
  77. Brown T, Pincus J. Phenytoin (Dilantin) and other hydantoins. In: Brown T, Feldman R, (eds), Epilepsy. Little, Brown, and Co. Boston. 1983; 175-189. Review
  78. Osborn H, Zisfein J, Sparano R. Single dose oral phenytoin loading. Ann Emerg Med 1987; 16:407-412. Convenience cohort. 51 patients
  79. Ratanakorn D, Kaojarern S, Phuapradit P, Mokkhavesa Single oral loading dose of phenytoin: a pharmacokinetic study. J Neurological Sci 1997; 147:89-92. Prospective, two groups: 19 volunteers, 14 seizure patients
  80. Mayden C, Kruger A, Muller F, et al. Acute oral loading of carbamazepine-CR and phenytoin in a double blind randomized study of patients at risk of seizures. Epilepsia 1994; 35:189-193. Double blind. 48 adults
  81. Simon RP: Physiologic consequences of status epilepticus. Epilepsia. 1985;26(Suppl 1):S58-S66.
  82. Boggs JG, Marmarou A, Agnew JP, Morton LD, Towne AR, et al: Hemodynamic monitoring prior to and at time of death in status epilepticus. Epilepsy Res. 1998;31:199-209.
  83. Meldrum B, Vigouroux R, Brierley J. Systemic factors and epileptic brain damage. Arch Neurol 1973; 29:82-87. Animal study. 8 baboons
  84. Privitera MD, Strawsurg RH. Electroencephalographic monitoring in the emergency department. Emergency Medical Clinics NA 1994;12:1089-1101.
  85. Leppik IE, Derivan AT, Homan RW, et al. Double-blind study of lorazepam and diazepam in status epilepticus. JAMA 1983;249:1452-4.
  86. Treiman D, Pharmacokinetics and clinical use of benzodiazepines in the management of status epilepticus. Epilepsia 1989; 30:4-10. Review 47 studies; 1455 patients
  87. Prasad K, Al-Roomi K, Krishnan PR, Sequeira R. Anticonvulsant therapy for status epilepticus. The Cochrane Database of Systematic Reviews 2005, Issue 4. Art. No.: CD003723. DOI: 10.1002/14651858.CD003723.pub2.
  88. McCormick EM, Lieh-lai M, Knazik S, Negro M. A prospective comparison of midazolam and lorazepam in the initial treatment of status epilepticus in the pediatric patient. Epilepsia 1999;40(7):160.
  89. Singhi S, Murthy A, Singhi P, Jayashree M. Continuous midazolam versus diazepam infusion for refractory convulsive status epilepticus. Journal of Child Neurology 2002;17:106-10.
  90. Dreifuss FE. Rosman NP. Cloyd JC, et al. A comparison of rectal diazepam gel and placebo for acute repetitive seizures.  Engl J Med 1998; 338:1869-75. Randomized Controlled Trial. 125 children
  91. Pellock JM, Mitchell WG, Cloyd JC. Diastat (diazepam rectal gel) in the treatment of acute repetitive seizures in adults. Epilepsia 1998;39(6):126.
  92. Manno EM, New management strategies in the treatment of status epilepticus, Mayo Clin Proc. 2003;78:508-18
  93. Donovan P. Phenytoin administration by constant intravenous infusion: Selective rates of administration. Ann Emerg Med 1991; 20:139-142.
  94. Earnest M, Marx J, Drury L. Complications of intravenous phenytoin for acute treatment of seizures. JAMA 1983; 249:762-765.
  95. Browne T. The pharmacokinetics of agents used to treat status epilepticus. Neurology 1990;40:28-32.
  96. Osorio I, Reed R, Treatment of refractory generalized tonic clonic status epilepticus with pentobarbital anesthesia after high dose phenytoin. Epilepsia 1989; 30:464-471. Case series. 13 patients).
  97. Kilarski DJ, Buchanan C, Von Behren L. Soft-tissue damage associated with intravenous phenytoin. N Engl J Med 1984;3111:1186-7
  98. O’Brien TJ, Cascino GD, So EL, Hanna DR. Incidence and clinical consequence of the purple glove syndrome in patients receiving intravenous phenytoin therapy. Neurology 1998;51:1034-9
  99. Burneo JG, Anandan JV, Brakley GL. A prospective study of the incidence of the purple glove syndrome. Epilepsia 2001;42:1156-9
  100. Gellerman GL, Martinez C: Fatal ventricular fibrillation following intravenous sodium diphenylhydantoin therapy. JAMA 1967; 200:161-2. Case Report.
  101. Unger AH, Sklaroff HJ: Fatalities following intravenous use of sodium diphenylhydantoin for cardiac arrhythmias. JAMA 1967; 200:159-160. Case Report.
  102. Zoneraich S, Zoneraich O, Siegel J: Sudden death following intravenous sodium diphenylhydantoin. Am Heart J 1976; 91:375-7. Case report.
  103. Wilder BJ (ed). The use of parental antiepileptic drugs and the role for Fosphenytoin. Neurology 1996; 46:S1-S28. Review
  104. Appleton RE, Sweeney A, Choonara I, Robson J, Molyneux E. Lorazepam versus diazepam in the acute treatment of epileptic seizures and status epilepticus. Develpmental Medicine and Child Neurology 1995;37
  105. Chamberlain JM, Altieri MA, Futterman C et al.. A prospective, randomized study comparing intramuscular midazolam with intravenous diazepam for the treatment of seizures in children. Pediatr Emerg Care 1997;13:92-4.
  106. Towne AR, DeLorenzo RJ. Use of intramuscular midazolam for status epilepticus. J Emerg Med. 1999;17:323-8
  107. Fischer JH, Patel TV, Fischer PA. Fosphenytoin: clinical pharmacokinetics and comparative advantages in the acute treatment of seizures. Clin Pharmacokinet 2003;42:33-58.
  108. Leppik I, Boucher R, Wilder B, et al. Phenytoin pro-drug: Preclinical and clinical studies. Epilepsia 1989 (suppl 2); 30:S22-S26. Open label non-blinded. 25 volunteers
  109. Browne TR, Kugler AR, Eldon MA. Pharmacology and pharmacokinetics of fosphenytoin. Neurology 1996;46(6 Suppl 1):S3-S7
  110. Devinsky O, Leppik I, Willmore LJ, et al. Safety of intravenous valproate. Ann Neurol. 1995;38:670-4
  111. Giroud M, Gras D, Escousse A, Dumas R, Venaud G. Use of injectable valproic acid in status epilepticus. Drug Investigation 1993;5:154-159. (23 patients)
  112. Hovinga CA, Chicella MF, Rose DF, Eades SK, Dalton JT, Phelps SJ. Use of intravenous valproate in three pediatric patients with nonconvulsive or convulsive status epilepticus. Ann Pharmacother. 1999;33:579-584
  113. Venkataraman V, Wheless JW. Safety of rapid intravenous infusion of valproate loading doses in epilepsy patients. Epilepsy Res 1999;35:147-153.
  114. Limdi NA, Faught E: The safety of rapid valproic acid infusion. Epilepsia 2000;41:1342-1345.
  115. Sinha S, Naritoku DK: Intravenous valproate is well tolerated in unstable patients with status epilepticus. Neurology 2000;55:722-724.
  116. Naritoku DK. Mueed S. Intravenous loading of valproate for epilepsy. Clinical Neuropharm 1999; 22:102-6. Review 
  117. Raskind JY, El-Chaar GM. The role of carnitine supplementation during valproic acid therapy. Ann Pharmacother 2000;34:630-638.
  118. Powell-Jackson PR, Tredger JM, Williams K. Hepatotoxicity to sodium valproate: a review. Gut 1984;25:673-687.
  119. Shaner DM, McCurdy SA, Herring MO, Gabor AJ. Treatment of status epilepticus: a prospective comparison of diazepam and phenytoin versus phenobarbital and optional phenytoin, Neurology 1988;38:202-7.
  120. Marik PE, Varon J. The Management of Status Epilepticus. Chest. 2004;126:582-591.
  121. Parent J, Lowenstein D. Treatment of refractory generalized status epilepticus with continuous infusion of midazolam. Neurology 1994; 44:1837-1840. Retrospective case series. 4 patients
  122. Kumar A, Bleck TP. Intravenous midazolam for the treatment of refractory status epilepticus. Crit Care Med 1992;20:483-8.
  123. Claassen J, Hirsch LJ, Emerson RG, Mayer SA. Treatment of refractory status epilepticus with pentobarbital, propofol, or midazolam: a systematic review. Epilepsia 2002; 43: 146-153.
  124. Labar D, Ali A, Root J. High-dose intravenous lorazepam for the treatment of refractory status epilepticus. Neurology 1994; 44:1400-1403. Case series. 9 patients
  125. Brown LA, Levin GM. Role of propofol in refractory status epilepticus. Annals of Pharmacotherapy, 1998;32:1053-59.
  126. Cannon ML, Glazier SS, Bauman LA. Metabolic acidosis, rhabdomyolysis, and cardiovascular collapse after prolonged propofol infusion. J Neurosurg 2001;95:1053-56.
  127. Bray RJ. Propofol infusion syndrome in children. Paediatr Anaesth 1998;8:491-9.
  128. Makela JP, Livanainen M, Pieninkeroinen IP. Seizures associated with propofol anesthesia. Epilepsia 1993;34:832-5.
  129. Praasad A, Worrall BB, Bertram EH, Bleck TP. Propofol and midazolam in the treatment of Refractory Status Epilepticus. Epilepsia, 2001;42:380-6.
  130. Parviainen I, Uusaro a, Kalviainen R, et at. High-dose thiopental in the treatment of refractory status epilepticus in the intensive care unit. Neurology, 2002;59:1249-51.
  131. Osorio, Van Ness P. Pentobarbital and EEG burst suppression in treatment of status epilepticus refractory to benzodiazepines and phenytoin. Epilepsia 1990; 31:61-67. Case series. 7 cases
  132. Lowenstein D, Aminoff M, Simon R. Barbiturate anesthesia in the treatment of status epilepticus: Clinical experience with 14 patients. Neurology 1988; 38:395-400. Case series. 14 patients
  133. Walker L, Slovis C. Lidocaine in the treatment of status epilepticus. Acad Emerg Med 1997; 4:918-922 (evidence based review)
  134. Pascual J, Sedano M, Polo J. Intravenous lidocaine for status epilepticus. Epilepsia 1988; 29:584-589 (case series, 8 patients)
  135. Lampl Y, Eshel Y, Gilad R, et al. Chloral hydrate in intractable status epilepticus. Ann Emerg Med 1990; 19:674-676 (case series 5 patients)
  136. Yeoman P, Hutchinson A, Byrne A, et al. Etomidate infusions for the control of refractory status epilepticus. Intensive Care Med 1989; 15:255-259 (8 patients)
  137. Krumholz A, Sung G, Fisher R, et al. Complex partial status epilepticus accompanied by serious morbidity and mortality. Neurology 1995; 45:1499-1504. Case series. 10 patients;
  138. Lee S, Nonconvulsive status epilepticus: ictal confusion in later life. Arch Neurol 1985;42:778-781. Case series 11 patients;
  139. Ellis J, Lee S. Acute prolonged confusion in later life as an ictal state. Epilepsia 1978;19:119-127. Case series. 6 patients;
  140. Thompson S, Greenhouse A, Petit mal status in adults. Ann Intern Med 1968;68:1271-1278. Case series. 4 patients;
  141. Tomson T, Lindbom U, Nilsson B, Nonconvulsive status epilepticus in adults: thirty-two consecutive patients from a general hospital population. Epilepsia 1992;33:829-835. Case series. 32 patients
  142. Thomas P, Beaumanoir A, Genton P, et al, ‘De novo’ absence status of late onset: report of 11 cases. Neurology 1992;42:104- 110. Case series. 11 patients
  143. Cascino G, Non-convulsive status epilepticus in adults and children, Epilepsia 1993;34(suppl 1):S21-S28. Review
  144. DeGiorgio C, Gott P, Rabinowicz A, et al. Neuron-specific enolase, a marker of acute neuronal injury, is increased in complex partial status epilepticus. Epilepsia 1998; 37:606-609. Prospective cohort. 8 patients
  145. Rathlev N, D’Onofrio G, Fish S, et al. The lack of efficacy of phenytoin in the prevention of recurrent alcohol-related seizures. Ann Emerg Med 1994; 23:513-518. Prospective, randomized, double blind study. 147 patients.
  146. Schoenenberger RA and Heim SM. Indication for computed tomography of the brain in patients with first uncomplicated generalised seizure. BMJ; 1994 309:986-989
  147. Brust JC. Acute neurologic complications of drug and alcohol abuse. Neurologic Clinics; 1998: 16:503-519
  148. Lacy JR et al: Brain infarction and hemorrhage in young and middle-aged adults. West J Med 1984:141:329.
  149. McMicken D, Freedland E. Alcohol-related seizures: Pathophysiology, differential diagnosis, evaluation, and treatment. Emerg Med Clin No Amer 1994; 12:1057-1080. Review.
  150. Sand T, Brathen G, Michler R, et al: Clinical utility of EEG in alcohol-related seizures. Acta Neurol Scand 2002: 105: 18-24.
  151. Rathlev N, Ulrich A, Fish S, D’Onofrio G. Clinical characteristics as predictors of recurrent alcohol related seizures. Acad Emerg Med 2000; 7:886-891. Retrospective review. 105 patients)
  152. D’Orofrio G, Rathlev N, Ulrich A, et al. Lorazepam for the prevention of recurrent seizures related to alcohol. NEMJ 1999; 340:915-919. Double blind placebo controlled. 229 patients)
  153. Chance J. Emergency Department treatment of alcohol withdrawal seizures with phenytoin. Ann Emerg Med 1991; 20:520-522. Prospective, randomized, double blind study. 55 patients).
  154. Gospe SM Jr. Pyridoxine-dependent seizures: new genetic and biochemical clues to help with diagnosis and treatment. Curr Opin Neurol. 2006 Apr;19(2):148-53.
  155. Miller J, Robinson A, Percy AK. Acute isoniazid poisoning in childhood. Am J Dis Child 1980;134:290-2.
  156. Saad SF, el Masry AM, Scott PM. Influence of certain anticonvulsants on the concentration of GABA in the cerebral hemi- spheres of mice. Eur J Phamacol 1972;17:386-92.
  157. Gospe SM Jr, Bell RM. Hospital pharmacy and emergency department availability of parenteral pyridoxine. Pediatr Emerg Care. 2005 Sep;21(9):586-8.
  158. Santucci KA. Shah BR. Linakis JG. Acute isoniazid exposures and antidote availability. Pediatr Emerg Care 1999; 15:99-101. Review
  159. Kunisaki T, Augenstein L. Drug and toxin induced seizures. Emerg Clin No Amer 1994; 12:1027-1056. Review
  160. Rashkin MC, Youngs C, Penovich P. Pentobarbital treatment of refractory status epilepticus. Neurology 1987;37:500-503.
  161. Orser BA, Bertlik M, Wang LY, MacDonald JE. Inhibition by propofol (2,6 di-isopropylphenol) of the N-methyl-D-aspartate subtype of glutamate receptor in cultured hippocampal neurones. Br J Pharmacol 1995;116:1761-1768.
  162. Annegers J, Hauser W, Coan S, et al. A population-based study of seizures after traumatic brain injuries. NEJM 1998; 338:20-24. Retrospective cohort. 4541 patients, all ages
  163. Temkin NR, Haglund MM, Winn HR. Causes, prevention, and treatment of post-traumatic epilepsy. New Horiz. 1995 Aug;3(3):518-22. Review.
  164. The EURAP Study Group, Seizure control and treatment in pregnancy: Observations from the EURAP Epilepsy Pregnancy Registry, Neurology 2006;66:356-360.
  165. Schmidt D, Janz D, et al. Change of seizure frequency in pregnant epileptic women. J Neurol Neruosurg Psychaitry 1983; 46:751-755.
  166. ACOG educational bulletin. Seizure disorders in pregnancy. No. 231, December 1996. Committee on Educational Bulletins of the American College of Obstetricians and Gynecologists. Int J Gynaecol Obstet 1997;56:279-86.
  167. Schmidt D, Beck-Mannagetta G, Janz D, Koch S. The effect of pregnancy on the course of epilepsy: a prospective study. In: Janz D, Dam M, Richens A, eds. Epilepsy, pregnancy, and the child. New York: Raven Press, 1982:39-49.
  168. Yerby MS, Friel PN, McCormick K, Koerner M, Van Allen M, Leavitt AM, et al. Pharmacokinetics of anticonvulsants in pregnancy: alterations in plasma protein binding. Epilepsy Res 1990;5:223-8.
  169. Delgado-Escueta A, Dieter J. Consensus guidelines: Preconception counseling, management, and care of the pregnant woman with epielspy. Neurology 1992;42(suppl 5): 149- 160. Consensus
  170. Lubarsky SL, Barton JR, Friedman SA, Nasreddine S, Ramaddan MK, Sibai BM. Late postpartum eclampsia revisited. Obstet Gynecol 1994;83:502–5.
  171. Chames MC, Livingston JC, Invester TS, Barton JR, Sibai BM. Late postpartum eclampsia: a preventable disease? Am J Obstet Gynecol 2002;186:1174–7.
  172. The Eclampsia Trial Collaborative Group. Which anticonvulsant for women with eclampsia? Lancet 1995; 345:1455-1463. Randomized, double blind study. 1680 patients
  173. Duley L, Henderson-Smart D. Magnesium sulfate versus phenytoin for eclampsia. (Cochrane Review). In: The Cochrane Library, Issue 3, 2003. Oxford: Update software.
  174. National High Blood Pressure Education Program Working Group Report on High Blood Pressure in Pregnancy. Am J Obstet Gynecol. 1990 Nov;163(5 Pt 1):1691-712. Review.
  175. Savard G, Andermann F, Teitelbaum J, Lehmann H, Epileptic Munchausen’s syndrome: a form of pseudoseizures distinct from hysteria and malingering, Neurology 1988;38:1628-1629. Case report; Krumholz A, Niedermeyer E, Psychogenic seizures: a clinical study with follow-up data, Neurology 1983;33:498-502. Retrospective. 41 patients
  176. Howell S, Owen L, Chadwick D, Pseudostatus epilepticus, Quarterly J Med 1989;71;507-519. Review; Leis A, Ross M, Summers A, Psychogenic seizures: ictal characteristics and diagnostic pitfalls, Neurology 1992:42:95-99. Review
  177. Levitan M, Bruni J, Repetitive pseudoseizures incorrectly managed as status epilepticus, Can Med Assoc J 1986;134:1029-1031.Case series. 3 patients
  178. Reuber M, Elger CE. Psychogenic nonepileptic seizures: review and update. Epilepsy Behav 2003;4:205-16.
  179. Leis AA, Ross MA, Summers AK. Psychogenic seizures: ictal characteristics and diagnostic pitfalls. Neurology. 1992 Jan;42(1):95-9.
  180. Benbadis SR, Hauser WA. An estimate of the prevalence of psychogenic non-epileptic seizures. Seizure 2000;9:280-1.
  181. Gates JR. Epidemiology and classification of non-epileptic events. In: Gates JR, Rowan AJ, eds. Non-epileptic seizures. 2d ed. Boston: Butterworth-Heinemann, 2000:3-14.
  182. Benbadis SR, Agrawal V, Tatum WO 4th. How many patients with psychogenic nonepileptic seizures also have epilepsy? Neurology 2001;57:915-7.
  183. Scott D, Recognition and diagnostic aspects of non-epileptic seizures, in Riley T, Roy A (eds): Pseudoseizures. Baltimore, Williams and Wilkens Co., 1982. Book chapter
  184. Gates J, Ramani V, Whalen S, Loewenson R, Ictal characteristics of pseudoseizures, Arch Neurol 1985;42:1183-1187. Prospective video review. 50 patients
  185. Martin R, Burneo JG, Prasad A, Powell T, Faught E, Knowlton R, et al. Frequency of epilepsy in patients with psychogenic seizures monitored by video-EEG. Neurology 2003;61:1791-2.
  186. Devinsky O, Gordon E. Epileptic seizures progressing into nonepileptic conversion seizures. Neurology 1998; 51:1293- 1296. Case series, 4 patients
  187. Alsaadi TM, Thieman C, Shatzel A, Farias S. Video-EEG telemetry can be a crucial tool for neurologists experienced in epilepsy when diagnosing seizure disorders. Seizure 2004;13:32-4.
  188. Riggio S, Harner R, Frontal lobe epilepsy, Neuropsych Neuropsychol Behav Neurol 1992;2:283-293. Prospective. 12 patients
  189. Peguero E, Abou-Khalil B, Fakhoury T, Mathews G. Selfinjury and incontinence in psychogenic seizures. Epilepsia 1995; 36:586-591. Survey. 102 patients
  190. Luther J, McNamara J, Carwile S, et al, Pseudoepileptic seizures: methods and video analysis to aid diagnosis, Ann Neurol 1982;12;458-462. Prospective. 18 patients
  191. Rosenberry M, The eyes in hysterical states of unconsciousness, J Clin Neuro Ophthalmol 1982;2:259-260. Review
  192. Pakalnis A, Drake M, Phillips B, Neuropsychiatric aspects of psychogenic status epilepticus, Neurology 1991;41:1104-1106. Prospective convenience sample. 20 patients
  193. Massey E, Riley T, Pseudoseizures: recognition and treatment, Psychsomatics 1980;21:987-997. Review
  194. Alsaadi TM, Marquez AV. Psychogenic nonepileptic seizures. Am Fam Physician. 2005 Sep 1;72(5):849-56.
  195. Sillanpaa M, Jalava M, Kaleva O, Shinnar S. Long-term prognosis of seizures with onset in childhood. New Eng J Med 1998; 338:1715-1722. Prospective. 220 patients
  196. Hauser A. The prevalence and incidence of convulsive disorders in children. Epilepsia 1994; 35(suppl 2):S1-6. Review
  197. Penry J, Porter R, Dreifuss F, Simultaneous recording of absence seizures with videotape and electroencephalography: a study of 374 seizures in 48 patients. Brain 1975;98:427-432. Prospective cohort. 48 patients
  198. American Academy of Pediatrics. Practice parameter: The neurodiagnostic evaluation of the child with a first simple febrile seizure. Pediatrics 1996; 97:769-775. Evidence based clinical policy
  199. Knudsen F. Febrile seizures: Treatment and prognosis. Epilepsia 2000; 41:2-9. Review
  200. Annegers J, Hauser A, Shirts S, Kurland L. Factors prognostic of unprovoked seizures after febrile convulsions. New Engl J Med 1987; 316:493-498. Retrospective review of a prospective cohort. 687 patients
  201. Maytal J, Shinnar S, Moshe S, Alvarez L. Low morbidity and mortality of status epilepticus in children. Pediatrics 1989; 83:323-331. Retrospective with prospective followup. 97 patients
  202. van Stuijvenberg M. de Vos S. Tjiang GC. Steyerberg EW. Derksen-Lubsen G. Moll HA. Parents’ fear regarding fever and febrile seizures. Acta Paediatrica 1999; 88:618-22
  203. Teach SJ. Geil PA. Incidence of bacteremia, urinary tract infections, and unsuspected bacterial meningitis in children with febrile seizures. Pediatr Emerg Care 1999; 15:9-12. Retrospective review. 243 children
  204. Akpede GO. Localized extracranial infections in children with acute bacterial meningitis. Journal of Tropical Pediatrics 1994; 40:231-4
  205. Rosman N, colton T, Labazzo C, et al. A controlled trial of diazepam administered during febrile illnesses to prevent recurrence of febrile seizures. New Engl J Med 1993; 329:79- 84. Randomized double blind. 406 children
  206. American Academy of Pediatrics. Practice parameter: Long term treatment of the child with a simple febrile seizure. Pediatrics 1999; 103:1307-1309. Evidence based clinical policy
  207. Farrar HC, Chande VT, Fitzpatrick DF, Shema SJ. Hyponatremia as the cause of seizures in infants: a retrospective analysis of incidence, severity, and clinical predictors. Ann Emerg Med 1995; 26: 42–48.
  208. Mott S, Packer R, Soldin S. Neurologic manifestations of cocaine exposure in childhood. Pediatr 1994;93:557-560.
  209. Scott RC. Besag FM. Neville BG. Buccal midazolam and rectal diazepam for treatment of prolonged seizures in childhood and adolescence: a randomized trial Lancet 1999; 353:623-6. Randomized Controlled Trial
  210. Holmes GL. Buccal route for benzodiazepines in treatment of seizures. Lancet 1999;353:608-609.
  211. Lahat E, Goldman M, Barr J, Bistritzer T, Berkovitch. Comparison of intranasal midazolam with intravenous diazepam for treating febrile seizures in children: prospective randomized study. BMJ 2000;321:83-86.
  212. Earnest MP. Feldman H. Marx JA. Harris JA. Biletch M. Sullivan LP. Intracranial lesions shown by CT scans in 259 cases of first alcohol-related seizures. Neurology 1988; 38:1561-5. Retrospective. 259 patients
  213. Holland RW, Marx JA. Earnest MP. Ranniger S. Grand mal seizures temporally related to cocaine use: Clinical and diagnostic features Ann Emerg Med 1992;21:772-6
  214. Quigg M, Shneker B, Domer P. Current practice in administration and clinical criteria of emergent EEG. J Clin Neurophysiol, 2001;18:162-5.
  215. Krumholz A, Fisher R, Lesser R, Hauser A. Driving and epilepsy: A review and reappraisal. JAMA 1991:265:622-626. Review