ArticleCNS drugs2023
Trends and Differences in Status Epilepticus Treatment of Children and Adults Over 10 Years: A Comparative Study of Medical Records (2012-2021) from a University Hospital in Germany.
Article in CNS drugs, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.
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Who cites it
7 citing papers in PubMed, 1 synthesis or guideline pooled it, 8 citations in OpenAlex.
- Efficacy and safety of levetiracetam for pediatric convulsive status epilepticus in emergency settings: a systematic review and meta-analysis.BMC neurology · 2025Pooled it
- Reply to the letter to the editor regarding "diagnosis, treatment, and outcome prediction of non-convulsive status epilepticus in unconscious patients in intensive care units".Neurological research and practice · 2026Article
- Breaking the seizure cycle: Belgian expert consensus on the diagnostics and treatment of acute convulsive seizures in children.Acta neurologica Belgica · 2026Review
- Real-world Data on Adult Status Epilepticus from Latin America: Clinical Characteristics and Outcomes in a Mexican Tertiary Center.Epilepsy & behavior reports · 2026Article
- Diagnosis, treatment, and outcome prediction of non-convulsive status epilepticus in unconscious patients in intensive care units.Neurological research and practice · 2025Review
- Relative Bioavailability Study of Midazolam Intramuscularly Administered with the Needle-Free Auto-Injector ZENEONeurology and therapy · 2024Article
- Status epilepticus in patients with brain tumors and metastases: A multicenter cohort study of 208 patients and literature review.Neurological research and practice · 2024Article
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9 authors at 1 institution in 1 country.
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No grant is acknowledged in the PubMed record.
Abstract
BACKGROUND AND
objectivesOver the last decade, significant advancements have been made in status epilepticus (SE) management, influenced by landmark trials such as ESETT and RAMPART. The objectives of this study were to explore the evolution of drug treatments for patients with SE, to investigate its association with outcomes and mortality, and to evaluate differences in treatment patterns between adults and children for a potential shift in medication trends due to the above mentioned trials.
methodsThe medical records of patients with SE treated at University Hospital Frankfurt between 2012 and 2021 were evaluated for medication trends and outcomes. Children and adults were analyzed separately and jointly.
resultsThis study included 1151 SE episodes in 1021 patients (mean age = 53.3 ± 28.3 years; 52.5 % female [n = 533]). The overall percentage of patients with SE treated prehospital was stable over the last decade. More than half (53.6 %) of children were treated prehospital, compared with less than one-third (26.7 %) of adults. Prehospital midazolam use increased over time, while diazepam use decreased. Lorazepam was the most commonly used benzodiazepine in hospitals in 2012-2013, used in 40.8 % of all episodes. However, its use declined to 27.2 % in 2020-2021, while midazolam use increased to 44.0 %. While the use of older antiseizure medications (ASMs) such as phenobarbital (p = 0.02), phenytoin (p < 0.001), and valproate (p < 0.001) decreased, the use of newer ASMs such as levetiracetam and lacosamide significantly increased (p < 0.001). Propofol and continuous midazolam infusion remained the most used third-line therapy drugs. Overall mortality was 16.5 % at discharge and 18.9 % at 30 days. Mortality rates did not change between 2012 and 2021.
conclusionMidazolam has become the preferred benzodiazepine in pre- and in-hospital settings, both in children and adults. The same applies to the increased use of levetiracetam and lacosamide over time in children and adults, while phenobarbital, phenytoin, and valproate use decreased. Continuous midazolam infusion and propofol remain the most frequently used anesthetic drugs. Mortality and outcome remain stable despite changes in medication patterns.
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