EAN 2024 | Prolonged epileptic seizure treatment guidelines explained

Reetta Kälviäinen, MD, PhD, University of Eastern Finland, Kuopio University Hospital, Kuopio, Finland, explains the newly published recommendations for the outpatient management of prolonged seizures and seizure clusters. Prolonged focal seizures are defined as lasting ≥ 5 minutes and prolonged absence or tonic-clonic (clonic phase) seizures have a threshold of ≥ 2 minutes. The new guidelines developed by an expert working group indicate that HCPs should no longer wait for a seizure to subside in at-risk patients, instead Rapid Emergency Seizure Termination (REST) using an emergency medication is the optimal course of action. Patients with a history of prolonged seizures or progression to more severe seizures should be offered a REST medication. REST is available for patients undergoing active treatment and palliative treatment, to prevent unnecessary hospitalizations and progression to higher-level emergencies such as status epilepticus. Prof. Kälviäinen states that seizures should be treated only in the earlier disease stages for those in palliative care and avoid unnecessary treatments. This interview took place at the European Academy of Neurology (EAN) Annual Meeting 2024 in Helsinki, Finland.

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