The history of status epilepticus and its treatment

Abstract

SUMMARYDespite the fact that status epilepticus was been recognized since antiquity, its existence was largely ignored until the mid-nineteenth century. In this review we cover the medical literature of status epilepticus from the late nineteenth century until the early 1970s when the modern era of status epilepticus began. We pay particular attention to the impact of the ILAE and its principal members on the understanding and awareness of status epilepticus. We also cover the evolution of treatment regimens advocated for status epilepticus from the late nineteenth century to the early 1970s when the benzodiazepines were established as first line treatments.

Anticonvulsant discovery through animal models of status epilepticus induced by organophosphorus nerve agents and pesticides

“…As the dangers of these chemicals became more and more clear, researchers began developing monkey models that were predicted to closely recapitulate human responses. The first observation that NAs could induce seizure activity in nonhuman primates occurred in 1968, at a time when clinicians and researchers were just beginning to appreciate the importance of SE and the utility of the electroencephalogram (EEG) in understanding it . Shortly thereafter, benzodiazepines emerged as the frontline therapy for clinical SE and were also demonstrated to be an effective treatment for NA‐induced seizures in macacques .…”

Super‐refractory status epilepticus: An approach to therapy in this difficult clinical situation

“…There are individual reports of a range of disparate physical therapies used to treat super‐refractory SE. These include electroconvulsive therapy (ECT) (an old therapy; Cline & Roos, 2007), transcranial magnetic stimulation (Misawa et al., 2005; Rotenberg et al., 2009), vagus nerve stimulation (Winston et al., 2001; De Herdt et al., 2009), and drainage of the cerebrospinal fluid (CSF) (Kohrmann et al., 2006; a very old therapy—see Neligan & Shorvon, 2009). Other cases have been treated by emergency neurosurgery (Lhatoo & Alexopoulos, 2007).…”

Acute down‐regulation of adenosine A1 receptor activity in status epilepticus

“…Status epilepticus (SE) is a medical emergency associated with considerable mortality and morbidity (Neligan & Shorvon, 2009). SE rapidly becomes refractory to drug treatment (Mazarati et al., 1998a) and first‐line therapy is often ineffective (Treiman et al., 1998).…”