19 - status epilepticus

Question 1

def. status

Answer 1

5 or more minutes without gaining consciousness in between

Question 2

7 main etiologies of SE

Answer 2

1. withdrawal
2. toxins
3. acute structural injury - brain, stroke
4. cerebral injury
   - infection, hypoxia
5. chronic structural
   - prior intracranial injury or surg
   - cerebral palsy
6. metabolic
7. chroncic epilepsy

Question 3

M and M of SE

Answer 3

first episode 20-30%

• over 30 minutes has neuro damage
• generalized respnd better to Tx

Question 4

5 important Hx questions

Answer 4

1. time of onset
2. Hx of prior
3. injestion of toxins/etoh
4. assoc. Sx
5. Mex Hx

Question 5

Phx for SE

Answer 5

mainly need to take care of ABCs

Question 6

investigations for do

Answer 6

1. glucose
2. CBC, lytes, drug levels, VBG, Ca, Mg,
3. ECG, LP, CT head - defer until seizure stopped

Question 7

Tx of SE

Answer 7

ABC
D50W if hypoG
benzos and phenytion

Question 8

3 benzos to use

Answer 8

1. lorazepam -2-4mg IV - preferred
2. diazepam 5-10mg, IV
3. midaz - 10mg IM

Question 9

3 meds to use of not stopping

Answer 9

ICU for

1. phenobarbitol
2. midaz IV
3. propofol

Question 10

6 non CNS complications of SE

Answer 10

1. CVstress
2. hypotension
3. resp failure
4. rhabdo
5. increased para - bronch secretion
6. non cardio PEdema

Question 11

when to suspect pseudo seizures

Answer 11

when other Tx are not working