Neurology

Question 1

SE: What general measures are important if someone is in status epilepticus

Answer 1

• Padded bed rails
• Time seizure
• Obs

Question 2

SE: Explain airway management in status epilepticus

Answer 2

• Give 15L oxygen via non-rebreathe

- In inter-ictal state consider oropharyngeal airway (do not insert mid-seizure)

Question 3

What bloods should be taken in status epilepticus

Answer 3

FBC
Coagulation Profile 
U+Es
Toxicology screen 
Anti-epileptic levels 
LFT

Question 4

SE: What should be given in 0-5 minutes if malnutrition is suspected

Answer 4

• IV Pabrinex (250mg IV - 30 minutes)

- Glucose (100ml 10%)

Question 5

What is given for SE at 5-20 minutes

Answer 5

Lorazepam

Question 6

What dose of lorazepam is given for SE

Answer 6

4mg IV

Question 7

What is the infusion rate of lorazepam

Answer 7

2mg/min

Question 8

If no IV access, what should be given as an alternative to lorazepam

Answer 8

Buccal midazolam (10mg)

Question 9

When can benzodiezapines be repeated if no response

Answer 9

After 10-20 minutes

Question 10

What is the maximum dose of benzodiezapines that can be given

Answer 10

2 doses (whatever type)

Question 11

When should a CT head be ordered

Answer 11

• No PMH Epilepsy
• New-onset neurological deficit
• Refractory SE

Question 12

If patient does not respond to benzodiezapines who should be contacted

Answer 12

Neurology SpR on-call

Question 13

What is a patient given if they do not respond to 2 doses of benzodiezapines

Answer 13

IV Phenytoin

Question 14

What is the dose of phenytoin

Answer 14

20mg/Kg IV

Infuse at 50mg/min

Question 15

If phenytoin is given, what monitoring should be ordered

Answer 15

Continuous cardiac monitoring

Question 16

What is done if the patient does not respond to phenytoin

Answer 16

ITU
Anaesthetise
Continuous EEG