1(E): Status Epilepticus Flashcards
Define status epilepticus
- Failure seizure to terminate in 5-minutes
- Two or more seizures with failure to regain consciousness between
What is most common cause of status epilepticus
Withdrawal anti-epileptics
What else can cause status epilepticus
- Infection
- Metabolic
- Drug-toxicity
- Structural lesions
What seizure-disorder has highest risk of status
Tonic-Clonic
In hospital, what is first management for status epilepticus
Protection patient - padded bed rails
What is second-line for status epilepticus
High-flow oxygen via non re-breathe mask (15L)
What is third-line for status epilepticus
Measure capillary glucose.
Give pabrinex then glucose
How much glucose is given if hypoglycaemia
100ml/h 10% Glucose
What medication is given first in status
IV lorazepam
What is given if status persists
Another dose of benzodiazepines. (Give maximum two doses)
What is second line-medication if status persists despite two doses benzodiazepine
IV Phenytoin
When is phenytoin not given
HB
Bradycardia
Already on phenytoin
If seizure persists despite phenytoin what is given
Contant ITU for sedation (Profol, thoipentone, Midazolam). Continue for 12h after last EEG seizure recorded
What are acute complications of status
- Metabolic acidosis
- Excitatory toxicity causing further seizures
- Posterior shoulder dislocation
