Seizures

Question 1

What are some issues that can cause a seizure?

Answer 1

Hypoglycaemia
Hypoxia
Head Trauma
Hyperthermia

Question 2

How many unprovoked seizures must a patient have before they are diagnosed with epilepsy?

Answer 2

Two

Question 3

Midazolam is given to prevent what issues with a seizing patient?

Answer 3

Hypoxia
Aspiration
Physical Injury

Question 4

In Status Epilepticus how many seizures can be refractory to initial drug therapy?

Answer 4

40%

Question 5

Management of Generalised Seizures >5 mins using Midazolam?

Answer 5

IM Midazolam 0.15mg/kg up to a max single dose of 10mg
IM Midazolam 0.075mg/kg if >65 or frail (<40kg)
Repeat once after 5 mins to a max of 20mg
OR
IV Midazolam 0.15mg/kg to max single dose of 5mg
-administer over 4 mins
IM Midazolam 0.075mg/kg if >65 or frail (<40kg) to a max of 2.5mg

Question 6

Management of Generalised Seizures >5 mins using Levetiracetam?

Answer 6

IV/IO Levetiracetam over 15mins
- >16 years 60mg/kg up to 4.5g
- <16 years 40mg/kg up to 3g
IF IV/IO not possible
IM Midazolam 0.15mg/kg to single max dose of 10mg
-total max dose via any route 0.45mg/kg (30mg)

Question 7

Management of Postictal agitation?

Answer 7

IV/IO Midazolam
Consult EOC <8 years
8-15 years: up to 0.5mg
16-64 years: up to 1mg
>65 years: up to 0.5mg
Repeat every 5 mins to a max dose of 5mg
OR
IM Midazolam
8-64 years: 25mcg/kg up to 2.5mg (single dose only)

Question 8

Where do we transport our seizures patients?

Answer 8

Closest ED: Seizure resolves within first 5 mins or 1st Midazolam
RAH,FMC,LMH,WCH: Prolonged seizure, >2 midazolam doses, paediatric with first-time seizure