Lim, Kheng-Seang and Khoo, Ching -Soong and Fong, Si -Lei and Tan, Hui-Jan and Fong, Choong Yi and Mohamed, Ahmad Rithauddin and Rashid, Azmi Abdul and Law, Wan-Chung and Shaikh, Mohd Farooq and Khalid, Raihanah Abdul and Tan, Raymond Yen -Leong and Ahmad, Sherrini Bazir and Chinnasami, Suganthi and Wong, Sau-Wei and Raymond, Azman Ali and Malaysia, Epilepsy Council (2023) Management of status epilepticus in Malaysia: A national survey of current practice and treatment gap. Journal of Clinical Neuroscience, 114. pp. 25-31. ISSN 0967-5868, DOI https://doi.org/10.1016/j.jocn.2023.05.006.
Full text not available from this repository.Abstract
Introduction: Early and effective treatment is fundamental in status epilepticus (SE) management. At the initiative of the Epilepsy Council of Malaysia, this study aimed to determine the treatment gap in SE across different healthcare settings in Malaysia.Methods: A web-based survey was sent to clinicians involved in the management of SE, across all states and at all levels of healthcare services.Results: A total of 158 responses were received from 104 health facilities, including 23 tertiary government hospitals (95.8% of all government tertiary hospitals in Malaysia), 4 (80.0%) universities, 14 (6.7%) private, 15 (11.5%) district hospitals and 21 clinics. Intravenous (IV) diazepam was available in 14 (93.3%) district and 33 (80.5%) tertiary hospitals for prehospital management. Non-IV benzodiazepine (rectal diazepam and intra-muscular midazolam) was not widely available in prehospital services (75.8% and 51.5%). Intramuscular midazolam was underutilised (60.0% in district and 65.9% in tertiary hospitals). IV sodium valproate and lev-etiracetam were only available in 66.7% and 53.3% of the district hospitals, respectively. Electroencephalogram (EEG) services were available in only 26.7% of the district hospitals. Non-pharmacological therapies such as ketogenic diet, electroconvulsive therapy, and therapeutic hypothermia were not available in most district and tertiary hospitals for refractory and super-refractory SE.Conclusions: We identified several gaps in the current practice of SE management, including limited availability and underutilization of non-IV midazolam in prehospital services, underutilization of non-IV midazolam and other second-line ASMs, and lack of EEG monitoring in district hospitals and limited treatment options for re-fractory and super-refractory SE in tertiary hospitals.
| Item Type: | Article |
|---|---|
| Funders: | None |
| Uncontrolled Keywords: | Status epilepticus; Management; Malaysia; Gap |
| Subjects: | R Medicine > RC Internal medicine > RC0321 Neuroscience. Biological psychiatry. Neuropsychiatry |
| Divisions: | Faculty of Medicine |
| Depositing User: | Ms. Juhaida Abd Rahim |
| Date Deposited: | 08 Nov 2025 09:21 |
| Last Modified: | 08 Nov 2025 09:21 |
| URI: | http://eprints.um.edu.my/id/eprint/49762 |
Actions (login required)
 |
View Item |
