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BOOK REVIEW
Year : 2017  |  Volume : 65  |  Issue : 4  |  Page : 932-933

Status epilepticus. Practical guidelines in management


Department of Neurology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Department of Neurology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Raebareily Road, Lucknow, Uttar Pradesh, India

Date of Web Publication5-Jul-2017

Correspondence Address:
Usha Kant Misra
Department of Neurology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Department of Neurology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Raebareily Road, Lucknow, Uttar Pradesh
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/neuroindia.NI_513_17

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How to cite this article:
Misra UK. Status epilepticus. Practical guidelines in management. Neurol India 2017;65:932-3

How to cite this URL:
Misra UK. Status epilepticus. Practical guidelines in management. Neurol India [serial online] 2017 [cited 2019 Aug 23];65:932-3. Available from: http://www.neurologyindia.com/text.asp?2017/65/4/932/209515





Title : Status epilepticus. Practical guidelines in management

Editor : Ashalatha Radhakrishnan, Department of Neurology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, India

Paperback Publisher : Jaypee Brothers Medical Publishers (P) Ltd, New Delhi

Year : 2017

Number of pages : 115

Cost : Rs. 995

The definition of status epilepticus (SE), an acute emergency in Neurology practice, has been evolving over the last few decades.[1],[2] The definition, diagnosis and management of SE has changed and has especially advanced substantially over the past one decade. Treatment strategies today have a greater sense of urgency because of the realization that neuronal apoptosis and necrosis can be triggered very quickly. One has to be aware of the scientific rationale before any clinical decision is made in SE, the therapeutic strategies should be firmly grounded on pathophysiology, and a critical mind is needed while we choose the right drug at the right time from the several antiepileptic drugs available in the market, with more of them coming up to add to the dilemma in selecting them.[3]

Dr Ashalatha Radhakrishnan and her colleagues need to be complimented for striving hard and coming up with a welcome edition in Neurology literature in the form of a comprehensive text book on SE, which gives an in-depth analysis of the diagnosis and management of SE in a lucid manner, based on their vast experience in handling more than 200 cases over the past two decades. The book contains 10 chapters and succinct management protocols, contributed by 14 authors.

Chapter 1 on “Evolution of definitions of status epilepticus and non-convulsive status epilepticus” describes the progressive evolution of the definition of SE, which has changed over the years, especially with reference to 'time' or 'duration.' This is important to develop a uniform pattern of practice in our country by defining and thereby diagnosing the condition at the earliest. Chapter 2 on the “Prehospital management of status epilepticus” highlights the concept 'Time is brain' in SE and covers the crucial steps in pre-hospital management. The concept of 'Epilepsy Identity Card' provided at the end of chapter, if made a nationwide practice, will enable identification of patients with epilepsy and ensure their swift transport to a nearest emergency care center once they start having seizures in public places where little or no medical help is available. Chapter 3 on the “Investigations and monitoring protocol in status epilepticus” deals with the important investigations that should be done in SE patients to ascertain the etiology and also highlights the role of continuous EEG monitoring in patients having SE. Chapters 4-6 on “First-line,” “Second-line” and “Anesthetic agents” in SE, provide a comprehensive and updated coverage about the efficacy, mechanisms of action and safety profile of the various agents used for treatment of SE. Chapters 7 and 8 provide an elegant protocol-based approach to diagnosis and management of “Refractory and super-refractory status epilepticus;” this was much-needed as, information with regard to this important topic was lacking, especially in the Indian sub-continent. The authors have put a tremendous effort in reviewing the literature and providing an in-depth coverage of various therapies available for management of refractory and super-refractory SE. Chapter 9 on “Status epilepticus in special situations” provides important information with regard to how management strategies need to be altered while dealing with patients having various associated co-morbidities. This will be extremely useful information for physicians in other specialties who encounter SE often. The patient may not be in a position to be transported elsewhere because the primary condition needs to be tackled with priority. Chapter 10 provides a comprehensive coverage of “Identification and treatment of non-convulsive status epilepticus,” which is often undetected and, therefore, goes untreated. The author needs to be complemented for putting an extra-effort in adding EEG tracings, which has enabled easy understanding of this complicated topic. The two algorithms at the end of the book summarize a detailed yet simplified approach to the diagnosis and management of SE. This can be utilised in any intensive care unit since it gives a bird's eye view at a glance, which makes the management effortless, but systematic for beginners and intensivists.

The guidelines for managing status epilepticus have been provided in detail but the difficulties in applying these guidelines in the developing countries and the modifications required to apply these protocols in a resource-poor setting are also important. The role of anaesthetic drugs in the management of refractory SE is being questioned and needs to be considered, especially in the centres where mechanical ventilation facilities are sparse.

The authors are composed of faculty members from academic institutes as well as hospital consultants with experience in managing status epilepticus.

The presentation of the chapters is clear and concise and the book is well-illustrated by 14 tables, and 25 figures or charts and is adequately referenced. Each chapter is followed by conclusion, key points and some multiple-choice questions.

The book will be useful for neurologists, physicians, intensivist, paediatricians and anyone who manages status epilepticus. I hope that this book will have an e-version also for easy availability to the readers. The cost of Rs. 995 seems to be reasonable. I hope that this book will reach the interested readers and achieve the aim of improving the care of status epilepticus.



 
  References Top

1.
Dubey D, Kalita J, Misra UK. Status epilepticus: Refractory and super-refractory. Neurol India 2017;65, Suppl S1:12-7.  Back to cited text no. 1
    
2.
Murthy J. Refractory status epilepticus. Neurol India 2006;54:354-8.  Back to cited text no. 2
[PUBMED]  [Full text]  
3.
Murthy JM. New-onset focal epilepsy in adults: Antiepileptic drug treatment. Neurol India 2017;65, Suppl S1:78-82  Back to cited text no. 3
    




 

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