Anticonvulsants

Prompt recognition and treatment of seizures and status epilepticus in the neurointensive care unit is vital. Understanding of the available anticonvulsant treatment options, including mechanism of action, pharmacodynamics, adverse effects, and formulations available, can assist the clinician with selecting and adding agents to a treatment regimen where little evidence is available to guide therapy after the second or third line of therapy. Particular focus is placed on anticonvulsants commonly or potentially used for the treatment of adult patients with status epilepticus. Agents reviewed in this chapter include benzodiazepines, fosphenytoin/phenytoin, valproic acid, levetiracetam, phenobarbital, lacosamide, topiramate, perampanel, clobazam, brivaracetam, and anesthetic agents including midazolam, propofol, pentobarbital, and ketamine.