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. 2023 Apr:141:109141.
doi: 10.1016/j.yebeh.2023.109141. Epub 2023 Mar 3.

Detect, predict, and prevent acute seizures and status epilepticus

Tobias Loddenkemper  1
Affiliations

Detect, predict, and prevent acute seizures and status epilepticus

Tobias Loddenkemper. Epilepsy Behav. 2023 Apr.

Abstract

Status epilepticus is one of the most frequent pediatric neurological emergencies. While etiology is often influencing the outcome, more easily modifiable risk factors of outcome include detection of prolonged convulsive seizures and status epilepticus and appropriately dosed and timely applied medication treatment. Unpredictability and delayed or incomplete treatment may at times lead to longer seizures, thereby affecting outcomes. Barriers in the care of acute seizures and status epilepticus include the identification of patients at greatest risk of convulsive status epilepticus, potential stigma, distrust, and uncertainties in acute seizure care, including caregivers, physicians, and patients. Furthermore, unpredictability, detection capability, and identification of acute seizures and status epilepticus, limitations in access to obtaining and maintaining appropriate treatment, and rescue treatment options pose challenges. Additionally, timing and dosing of treatment and related acute management algorithms, potential variations in care due to healthcare and physician culture and preference, and factors related to access, equity, diversity, and inclusion of care. We outline strategies for the identification of patients at risk of acute seizures and status epilepticus, improved status epilepticus detection and prediction, and acute closed-loop treatment and status epilepticus prevention. This paper was presented at the 8th London-Innsbruck Colloquium on Status Epilepticus and Acute Seizures held in September 2022.

Keywords: Detection; Prediction; Prevention; Status epilepticus; Treatment.

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Conflict of interest statement

Declaration of Competing Interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Tobias Loddenkemper is part of pending patent applications to detect and predict seizures and diagnose epilepsy. He receives research support from the NIH, the Epilepsy Research Fund, the Epilepsy Foundation of America Epilepsy Venture Fund (Shark Tank Award), MIKU, and Epitel. He received device donations from Epitel, MIKU, Empatica, and neuroelectrics. In the past, he received research grants from Sage, Lundbeck, Eisai, Upsher-Smith, Proximagen, UCB, Mallinckrodt, Pfizer, and Empatica. In the past, he served as a consultant for Engage and Upsher Smith.

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