Wiznitzer M. Buccal midazolam for seizures. Lancet. 2005; 366: 182–3.
41 41 Wiznitzer M. Buccal midazolam is effective for acute treatment of seizures. J Pediatr. 2006; 148:143.
42 42 Towne AR, DeLorenzo RJ. Use of intramuscular midazolam for status epilepticus. J Emerg Med. 1999; 17:323–8.
43 43 Warden CR, Frederick C. Midazolam and diazepam for pediatric seizures in the prehospital setting. Prehosp Emerg Care. 2006; 10:463–7.
44 44 Chamberlain JM, Altieri MA, Futterman C, Young GM, Ochsenschlager DW, Waisman Y. A prospective, randomized study comparing intramuscular midazolam with intravenous diazepam for the treatment of seizures in children. Pediatr Emerg Care. 1997; 13:92–4.
45 45 Silbergleit R, Durkalski V, Lowenstein D, et al. Intramuscular versus intravenous therapy for prehospital status epilepticus. N Engl J Med. 2012; 366:591–600.
46 46 Vilke GM, Sharieff GQ, Marino A, Gerhart AE, Chan TC. Midazolam for the treatment of out‐of‐hospital pediatric seizures. Prehosp Emerg Care. 2002; 6:215–17.
47 47 Ribacoba‐Montero R, Salas‐Puig J. Simultaneous bilateral fractures of the hip following a grand mal seizure. An unusual complication. Seizure. 1997; 6:403–4.
48 48 Torreggiani WC, Lyburn ID, Harris AC, Nicolaou S. Odontoid fracture following an epileptic seizure. Australas Radiol. 2001; 45:359–61.
49 49 McArthur CL III, Rooke CT. Are spinal precautions necessary in all seizure patients? Am J Emerg Med. 1995; 13:512–13.
50 50 Gnanalingham K, Macanovic M, Joshi S, Afshar F, Yeh J. Non‐traumatic compression fractures of the thoracic spine following a seizure –treatment by percutaneous kyphoplasty. Minim Invasive Neurosurg. 2004; 47:256–7.
51 51 Kruitbosch JM, Schouten EJ, Tan IY, Veendrick‐Meekes MJ, de Vocht JW. Cervical spinal cord injuries in patients with refractory epilepsy. Seizure. 2006; 15:633–6.
52 52 Zwimpfer TJ, Brown J, Sullivan I, Moulton RJ. Head injuries due to falls caused by seizures: a group at high risk for traumatic intracranial hematomas. J Neurosurg. 1997; 86:433–7.
53 53 Walls RM, Sagarin MJ. Status epilepticus. N Engl J Med. 1998; 339:409.
54 54 Verma A, Bedlack RS, Radtke RA, VanLandingham KE, Erwin CW. Succinylcholine induced hyperkalemia and cardiac arrest death related to an EEG study. J Clin Neurophysiol. 1999; 16:46–50.
55 55 Lowenstein DH, Alldredge B. Managing status epilepticus. Lancet 1990; 336:1451.
56 56 Lowenstein DH. The management of refractory status epilepticus: an update. Epilepsia. 2006; 47 (Suppl 1):35–40.
57 57 Treatment of convulsive status epilepticus. Recommendations of the Epilepsy Foundation of America’s Working Group on Status Epilepticus. JAMA. 1993; 270:854–9.
58 58 ACEP Clinical Policies Committee, Clinical Policies Subcommittee on Seizures. Clinical policy: critical issues in the evaluation and management of adult patients presenting to the emergency department with seizures. Ann Emerg Med. 2004; 43:605–25.
59 59 Brophy GM, Bell R, Claassen J, et al. Guidelines for the evaluation and management of status epilepticus. Neurocrit Care. 2012; 17:3–23.
60 60 Kapur J, Elm J, Chamberlain JM, et al. Randomized trial of three anticonvulsant medications for status epilepticus. N Engl J Med. 2019; 381:2103–13.
61 61 Aggarwal P, Wali JP. Lidocaine in refractory status epilepticus: a forgotten drug in the emergency department. Am J Emerg Med. 1993; 1 1:243–4.
62 62 Pascual J, Sedano MJ, Polo JM, Berciano J. Intravenous lidocaine for status epilepticus. Epilepsia. 1988; 29:584–9.
63 63 Hamano S, Sugiyama N, Yamashita S, et al. Intravenous lidocaine for status epilepticus during childhood. Dev Med Child Neurol. 2006; 48:220–2.
64 64 Walker IA, Slovis CM. Lidocaine in the treatment of status epilepticus. Acad Emerg Med. 1997; 4:918–22.
65 65 Yeoman P, Hutchinson A, Byrne A, Smith J, Durham S. Etomidate infusions for the control of refractory status epilepticus. Intensive Care Med. 1989; 15:255–9.
66 66 Sheth RD, Gidal BE. Refractory status epilepticus: response to ketamine. Neurology. 1998; 51:1765–6.
67 67 Nathan BR, Smith TL, Bleck T. The use of ketamine in the treatment of refractory status epilepticus (abstract). Neurology. 2002; 58 (Suppl 3):A197.
68 68 Fountain NB, Adams RE. Midazolam treatment of acute and refractory status epilepticus. Clin Neuropharmacol. 1999; 22: 261–7.
69 69 Prasad A, Worrall BB, Bertram EH, Bleck TP. Propofol and midazolam in the treatment of refractory status epilepticus. Epilepsia. 2001; 42:380–6.
70 70 Stecker MM, Kramer TH, Raps EC, O’Meeghan R, Dulaney E, Skaar DJ. Treatment of refractory status epilepticus with propofol: clinical and pharmacokinetic findings. Epilepsia. 1998; 39:18–26.
71 71 Rossetti AO, Reichhart MD, Schaller MD, Despland PA, Bogousslavsky J. Propofol treatment of refractory status epilepticus: a study of 31 episodes. Epilepsia. 2004; 45:757–63.
72 72 Schor NF, Riviello JJ Jr. Treatment with propofol: the new status quo for status epilepticus? Neurology. 2005; 65:506–7.
73 73 Parviainen I, Uusaro A, Kälviäinen R, Mervaala E, Ruokonen E. Propofol in the treatment of refractory status epilepticus. Intensive Care Med. 2006; 32:1075–9.
74 74 Rossetti AO, Bromfield EB. Efficacy of rapid IV administration of valproic acid for status epilepticus. Neurology. 2005; 65: 500–1.
75 75 Wheless JW, Vazquez BR, Kanner AM, Ramsay RE, Morton L, Pellock JM. Rapid infusion with valproate sodium is well tolerated in patients with epilepsy. Neurology. 2004; 63:1507–8.
76 76 Peters CN, Pohlmann‐Eden B. Intravenous valproate as an innovative therapy in seizure emergency situations including status epilepticus–experience in 102 adult patients. Seizure. 2005; 14:164–9.
77 77 Fernandez IS, Abend NS, Agadi S, et al. Time from convulsive status epilepticus onset to anticonvulsant administration in children. Neurology. 2015; 84:2304–11.
78 78 Thio LL, Wainwright MS. Status epilepticus. For what are we waiting? Neurology. 2015; 84:2296–7.
CHAPTER 18 Stroke
Timothy P. Chizmar and Janelle M. Martin
Introduction
Stroke accounts for 1 out of every 19 deaths in the United States, and it is the fifth leading cause of death [1]. The concept of “time is brain” has become increasingly prevalent given the availability of stroke treatment options, as well as the emphasis on public education for the awareness of stroke symptoms and the need for timely evaluation. Rapid assessment and intervention allow for the possibility of a return to baseline neurologic function. EMS plays a critical role. Patient transfer to an appropriate receiving center, as well as early notification to it, serve to activate a health care system and facilitate time‐critical interventions. The value of EMS participation in public education regarding stroke awareness cannot be overstated, as early detection of symptoms is paramount to achieving the best possible outcomes.
In general terms, strokes are classified as either ischemic or hemorrhagic, but it is difficult to differentiate between these two subtypes in the prehospital setting. Radiographic imaging is required. Approximately 87% of strokes are ischemic, and 13% are hemorrhagic (10% are intracerebral hemorrhage [ICH] and 3% are subarachnoid hemorrhage). Approximately 610,000 strokes per year are believed to be first episodes, and approximately 185,000 are recurrent.
An ischemic stroke is caused by either in situ thrombus formation from atherosclerosis or an embolic event (usually from the heart or large vessels) that leads to the occlusion of a cerebral blood vessel and subsequent interruption of blood flow and oxygen supply to an area of the brain. For