Status epilepticus Flashcards
What is status epileptics
Recurrent epileptic seizures without full recovery of consciousness (Lasting > 30 minutes)
What are some precipitants of status epilepticus?
- Severe metabolic disorders - hyponatraemia, pydidoxine deficiency
- Infection
- Head trauma
- Sub-arachnoid haemorrhage
- Abrupt withdrawal of anti-convulsants
- Treating absence seizures with CBZ (Carbemazepine)
What are the 3 main types of status epilepticus
Generalised convulsive status
Non-convulsive status
Epilepsia partialis continua
What is generalised convulsive status
Generalised convulsions without cessation
How does generalised convulsive status cause damage?
Excess cerebral energy demand and poor substrate delivery causes lasting damage:
Glutamate release -> excitotoxicity -> neuronal death
What are some possible complications of generalised convulsive status?
Respiratory insufficiency
Hypoxia
Hypotension
Hyperthermia
Rhabdomyolysis
Mortality rare of generalised convulsive status
30%
What is non-convulsive status?
Conscious but in an ‘altered state’
What is epilepsia partialis continua
Continual focal seizures with consciousness preserved
How is epilepsia partialis continua diagnosed?
EEG
How is epilepsia partialis continua managed?
General anaesthesia
ITU admission
What is the mortality rate of epilepsia partialis continua?
90%
When is status epilepticus managed?
After 10 minutes
What is 1st line treatment of status epilepticus?
Benzodiazepine (Midazolam)
Describe the dosing regiment of benzodiazepine treatment for status epilepticus
Time seizure
After 10 minutes
Give 1 dose midazolam
After another 10 minutes
Give 1 dose midazolam
