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Volume 86, Pages (September 2018)

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1 Volume 86, Pages 33-41 (September 2018)
Hospital Emergency Treatment of Convulsive Status Epilepticus: Comparison of Pathways From Ten Pediatric Research Centers  Alejandra Vasquez, MD, Marina Gaínza-Lein, Iván Sánchez Fernández, MD, MPH, Nicholas S. Abend, MD MSCE, Anne Anderson, MD, J Nicholas Brenton, MD, Jessica L. Carpenter, MD, Kevin Chapman, MD, Justice Clark, MPH, William D. Gaillard, MD, Tracy Glauser, MD, Joshua Goldstein, MD, Howard P. Goodkin, MD, PhD, Yi-Chen Lai, MD, Tobias Loddenkemper, MD, Tiffani L. McDonough, MD, Mohamad A. Mikati, MD, Anuranjita Nayak, MD, Eric Payne, MD, James Riviello, MD, Dmitry Tchapyjnikov, MD, Alexis A. Topjian, MD, MSCE, Mark S. Wainwright, MD, PhD, Robert C. Tasker, MBBS, MD  Pediatric Neurology  Volume 86, Pages (September 2018) DOI: /j.pediatrneurol Copyright © 2018 The Authors Terms and Conditions

2 FIGURE 1 Timeline for treatment of pediatric status epilepticus in 10 pSERG hospitals: the timeline includes stabilization of the patient and use of first-phase (BZD) therapy, second-phase (non-BZD) therapy, and third-phase AEDs (i.e., repeat administration of second-phase drugs or use of continuous infusion. (In the text the three phases of drug therapy are denoted as first-line, second-line, and third-line, respectively.) The gray box represents the pathways with undefined end time for the third-phase therapy time interval. Two time points (t1 and t2) used by the International League Against Epilepsy (ILAE) have been added (see text for details). *Pathways that included a detailed treatment algorithm after the third-line therapy phase. Abbreviations: AED = antiepileptic drug; AES = American Epilepsy Society; BZD = benzodiazepine. Pediatric Neurology  , 33-41DOI: ( /j.pediatrneurol ) Copyright © 2018 The Authors Terms and Conditions

3 FIGURE 2 AED choice for each of the treatment phases of pediatric status epilepticus: the AES status epilepticus guideline8 is shown in the central part of the flow chart with yellow, orange, and blue to show the three phases of therapy (see left-hand side column). Either side of the AES guideline recommendations (see rhomboids) show the AED of choice for each therapy phase in the 10 pathways from United States pSERG hospitals. Key: (#) is the number of pathways recommending this option. Abbreviations: AED = antiepileptic drug; AES = American Epilepsy Society; DOC = drug of choice; IM = intramuscular; IN = intranasal; IV = intravenous; PE = phenytoin equivalents; PR = per rectum; pSERG = pediatric status epilepticus research group. (The color version of this figure is available in the online edition.) Pediatric Neurology  , 33-41DOI: ( /j.pediatrneurol ) Copyright © 2018 The Authors Terms and Conditions


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