Diagnóstico y tratamiento del estado epiléptico

Pedro Luis Rodríguez García

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Resumen

OBJETIVO: Revisar la literatura sobre los principios cardinales para el diagnóstico y tratamiento adecuado del estado epiléptico.

DESARROLLO: Se evalúa y enfatiza en los principios cardinales para el manejo adecuado del estado epiléptico: 1) La actualización de los criterios diagnósticos, los subtipos semiológicos y el diagnóstico etiológico de la entidad para obtener una mayor relevancia clínica, 2) Las vías para agilizar el inicio de la terapia de primera línea con benzodiacepinas y la aplicación inmediata de los restantes tratamientos en las formas refractarias, y 3) Los métodos para el diagnóstico precoz y tratamiento apropiado del estado epiléptico no convulsivo. En el diagnóstico del estado epiléptico se abordan las concepciones con respecto al tiempo de duración de las crisis epilépticas y los tipos de crisis epilépticas englobadas en la definición. Se adoptan los términos y descripciones semiológicas más actuales expresadas por la Liga Internacional contra la Epilepsia (ILAE). En un último acápite se abordan las pautas antiepilépticas iniciales y anestésicas que se indican para controlar las crisis epilépticas lo más rápido posible. También se delinean las medidas para evitar y tratar las complicaciones sistémicas relacionadas con el estado epiléptico y los efectos adversos de los antiepilépticos.

CONCLUSIONES: Se precisan de investigaciones amplias que valoren la efectividad de las terapias individuales acorde al mecanismo de las crisis epilépticas, semiología, duración, causas, complicaciones asociadas y cambios dinámicos que potencian el estado epiléptico y la lesión neuronal.

Palabras clave

Crisis psicógenas; Electroencefalografía; Epilepsia; Epilepsia del lóbulo frontal; Epilepsias mioclónicas; Epilepsia tipo ausencia; Epilepsia tónico–clónica; Estado epiléptico

Citas

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