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Neue Definitionen und Evidenz wurden bei der Erstellung der LL und des Clinical Pathway ber\u00fccksichtigt. Jeder epileptische Anfall, der l\u00e4nger als 5 Minuten anh\u00e4lt (oder \u2265\u202f2\u00a0Anf\u00e4lle \u00fcber einen Zeitraum von mehr als 5\u00a0Minuten ohne Wiedererlangen des neurologischen Ausgangsstatus), soll als SE behandelt werden.<\/jats:p>\n                  <jats:p>In der Diagnostik sollte initial eine CCT oder, wenn m\u00f6glich, eine MRT erfolgen. Das EEG spielt bei der Diagnosestellung und beim Therapiemonitoring von non-konvulsiven SE und zum Ausschluss bzw. Nachweis psychogener nichtepileptischer Anf\u00e4lle eine wesentliche Rolle. Der prognostische Einfluss von insbesondere entz\u00fcndlichen Begleiterkrankungen (z.\u202fB. Pneumonie) wurde besser belegt, weshalb entsprechende Laborparameter auch im Verlauf kontrolliert werden sollten und ggf. fr\u00fchzeitig eine antibiotische Therapie initiiert werden sollte.<\/jats:p>\n                  <jats:p>Die Therapie erfolgt in 4 Stufen: 1. Initialer SE: Gabe eines ausreichend hoch dosierten Benzodiazepins i.\u202fm., i.\u202fv. oder i.\u202fn.; 2.\u00a0Benzodiazepin-refrakt\u00e4rer SE: 1.\u00a0Wahl ist die i.v. Gabe von Levetiracetam oder Valproat; 3.\u00a0Refrakt\u00e4rer SE (RSE) und 4.\u00a0Superrefrakt\u00e4rer SE (SRSE): I.v. Propofol oder Midazolam alleine oder in Kombination oder Thiopental in an\u00e4sthetischen Dosen. Beim fokalen non-konvulsiven RSE kann unter Umst\u00e4nden auf die Einleitung eines therapeutischen Komas verzichtet werden. Bei SRSE sollte die ketogene Di\u00e4t zum Einsatz kommen. I.v. Ketamin oder inhalatives Isofluran kann erwogen werden. In Einzelf\u00e4llen kann die elektrokonvulsive Therapie und, bei resektabler epileptogener Zone, ein Epilepsie chirurgischer Eingriff erwogen werden. I.v. Allopregnanolon oder die Hyperthermie sollen nicht eingesetzt werden.<\/jats:p>","DOI":"10.1007\/s00115-020-01036-2","type":"journal-article","created":{"date-parts":[[2021,3,22]],"date-time":"2021-03-22T03:02:56Z","timestamp":1616382176000},"page":"1002-1030","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":61,"title":["S2k-Leitlinie: Status Epilepticus im Erwachsenenalter","S2k guidelines: status epilepticus in adulthood"],"prefix":"10.1007","volume":"92","author":[{"given":"F.","family":"Rosenow","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.","family":"Weber","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"Deutsche Gesellschaft f\u00fcr Neurologie (DGN)","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"\u00d6sterreichische Gesellschaft f\u00fcr Neurologie (\u00d6GN)","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,3,22]]},"reference":[{"key":"1036_CR1","doi-asserted-by":"publisher","first-page":"631","DOI":"10.1056\/NEJMoa002141","volume":"345","author":"BK Alldredge","year":"2001","unstructured":"Alldredge\u00a0BK, Gelb\u00a0AM, Isaacs\u00a0SM, Corry\u00a0MD, Allen\u00a0F, Ulrich\u00a0S, Gottwald\u00a0MD, O\u2019Neil\u00a0N, Neuhaus\u00a0JM, Segal\u00a0MR, Lowenstein\u00a0DH (2001) A comparison of lorazepam, diazepam, and placebo for the treatment of out-of-hospital status epilepticus. 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