Notfallversorgung und Erstbehandlung epileptischer Anfälle im Erwachsenenalter

Abstract

Suspected epileptic seizures are a frequent cause of emergency hospital care. After single seizures, the emergency management includes safety measures and diagnostic efforts to distinguish epileptic seizures from its manifold mimics and to possibly detect acute causes of epileptic seizures. Convulsive status epilepticus requires rapid anticonvulsant treatment according to established protocols and diagnostics to rule out underlying acute brain diseases. After a first seizure, typical EEG- and MRI findings may indicate an elevated recurrence risk, thereby justifying the ultimate diagnosis of epilepsy and initiation of anticonvulsant therapy. This article reviews the recent definition of epilepsy, summarizes clinical characteristics of epileptic seizures and its mimics and provides an overview of established therapies of single convulsive seizures, convulsive status epilepticus and early care of adults after first unprovoked seizures.

Bei einem vermuteten epileptischen Anfall muss schnell eine korrekte Diagnose erfolgen und zwischen „echtem“ epileptischem Anfall, konvulsiver Synkope, psychogenem Anfall oder selteneren Epilepsiesyndromen differenziert werden. Es muss dringlich geklärt werden, ob akut-symptomatische Auslöser vorliegen. Der vorliegende Artikel fasst die aktuellen Diagnosekriterien zusammen und gibt einen Überblick über etablierte Therapien in der Akutsituation.

Schlüsselwörter

Status epilepticus - erster epileptischer Anfall - Notfallmanagement - Erstversorgung - Antikonvulsiva

Key words

status epilepticus - first epileptic seizure - first aid treatment - anticonvulsant drugs

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