Neurology 4.11

Question 1

What are the major categories of status epilepticus?

Answer 1

1) convulsive (generalized tonic-clonic)

2) non-colvulsive (partial and generalized)

Question 2

What is the early compensated stage of status epilepticus?

Answer 2

1) lactic acidosis
2) increased adrenergic output [tachycardia, HTN]
3) cerebral edema

Question 3

What is the immediate medical menagement?

Answer 3

-determine blood glucose level
blood work
-IV thiamine [100 mg]

Question 4

What is the drug of choice for status epilepticus?

Answer 4

lorazepam (benzodiazepine)

phenytoin if unresponsive to first treatment in 5 minutes

Question 5

What is the clinical utliity of EEG?

Answer 5

seizure
syncope
dementia

Question 6

What are the limitations of EEG?

Answer 6

• does not assess entire brain/entire cortex

- routine study which may not detect pathology

Question 7

What are the major causes of status epilepticus?

Answer 7

1/3 - exacerbation of an existing seizure disorder – stopped medications
1/3 - initial (first) seizure of an idiopathic seizure disorder
1/3 - symptomatic precipitated by comorbidities (trauma, tumor, hypoglycemia, stroke, infection, etc.)