About Status Epilepticus
Epilepsy is a condition that can cause people to have seizures, which are bursts of electrical activity in the brain that affects how it functions. People who have seizures can experience a range of effects. Some people uncontrollably shake, while others experience a loss of awareness, and some patients have different experiences. Typically seizures last for a short period between a few seconds and a few minutes.
Longer seizures (usually defined as five or more minutes), or a series of seizures during which the person doesn’t regain consciousness, are known as status epilepticus. This type of seizure is a medical emergency that needs immediate treatment and can cause permanent damage to their brain and/or body. In the US this type of seizure is estimated to occur around 150,000 times or more per year.
Often, patients with status epilepticus are treated with antiepileptic medicines and benzodiazepines. However, according to the article on the UAB website, only 60-70% of patients respond to these medicines. For around 44% of people with status epilepticus more extreme treatments are necessary, at which point the condition is considered refractory.
For these patients, the next step is often to induce an artificial coma to stop the dangerous seizing. According to Dr Muhlhofer, a UAB assistant professor, this allows the brain to rest and reorganise.
However, there is not currently a standard procedure for this form of treatment, and it isn’t clear how long patients should be kept in the coma. Dr Muhlhofer intends to investigate this, and, eventually, may be able to produce better guidelines for doctors treating status epilepticus patients.
Dr Muhlhofer’s Research
Dr Muhlhofer is currently carrying out preliminary research with the longer-term aim of securing a grant to fund further work.
He has planned to study patients admitted to two medical centres over seven years that were put into an artificial coma. This research will draw on the ib2b, a collection of anonymous patient data at UAB. Of these patients, he will look at those who had another seizure within 48 hours of being brought out of sedation. Collected data is likely to include whether patients went on to develop complications from the treatment, such as deep vein thrombosis, urinary tract infections, or pneumonia, and what the patients’ statuses were when they were discharged (e.g. whether they were discharged with disability or the need for physical rehabilitation).
The next step will be to secure a grant to fund a randomised clinical trial of patients put into artificial comas, and find out what the effects of this are. Eventually, this could be used as the basis for better clinical guidelines for doctors.