Perioperative considerations for patients with epilepsy

“Epilepsy is the most common serious neurological disorder, with a prevalence of 0.5–1% of the population. Anaesthetists are frequently faced with patients with epilepsy undergoing
emergency or elective surgery and patients suffering seizures and status epilepticus in the intensive care unit (ICU).”

“Status epilepticus is a common neurological emergency and requires urgent management. Loss of benzodiazepine responsiveness is a prominent feature in established CSE and prompt treatment is important for seizure termination, in addition to appropriate resuscitation. Second-line agents include phenytoin or fosphenytoin and valproate, with newer agents such as levetiracetam and lacosamide yet to demonstrate clear evidence of efficacy. For refractory status epilepticus, general anaesthesia with midazolam, propofol, or thiopental is the currently accepted treatment.”

Perks A, et al . Anaesthesia and epilepsy. Br J Anaesth. 2012 Apr;108(4):562-71.

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