Status epilepticus Flashcards

1
Q

What is status epileptics

A

Recurrent epileptic seizures without full recovery of consciousness (Lasting > 30 minutes)

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2
Q

What are some precipitants of status epilepticus?

A
  • Severe metabolic disorders - hyponatraemia, pydidoxine deficiency
  • Infection
  • Head trauma
  • Sub-arachnoid haemorrhage
  • Abrupt withdrawal of anti-convulsants
  • Treating absence seizures with CBZ (Carbemazepine)
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3
Q

What are the 3 main types of status epilepticus

A

Generalised convulsive status
Non-convulsive status
Epilepsia partialis continua

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4
Q

What is generalised convulsive status

A

Generalised convulsions without cessation

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5
Q

How does generalised convulsive status cause damage?

A

Excess cerebral energy demand and poor substrate delivery causes lasting damage:

Glutamate release -> excitotoxicity -> neuronal death

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6
Q

What are some possible complications of generalised convulsive status?

A

Respiratory insufficiency
Hypoxia
Hypotension
Hyperthermia
Rhabdomyolysis

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7
Q

Mortality rare of generalised convulsive status

A

30%

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8
Q

What is non-convulsive status?

A

Conscious but in an ‘altered state’

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9
Q

What is epilepsia partialis continua

A

Continual focal seizures with consciousness preserved

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10
Q

How is epilepsia partialis continua diagnosed?

A

EEG

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11
Q

How is epilepsia partialis continua managed?

A

General anaesthesia
ITU admission

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12
Q

What is the mortality rate of epilepsia partialis continua?

A

90%

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13
Q

When is status epilepticus managed?

A

After 10 minutes

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14
Q

What is 1st line treatment of status epilepticus?

A

Benzodiazepine (Midazolam)

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15
Q

Describe the dosing regiment of benzodiazepine treatment for status epilepticus

A

Time seizure
After 10 minutes
Give 1 dose midazolam
After another 10 minutes
Give 1 dose midazolam

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16
Q

What are some 2nd line management options for status epilepticus?

A
  • Phenytoin (check levels)
  • Keppra
  • Valproate
17
Q

How is status epilepticus managed in ITU?

A

thiopentone or propofol

18
Q
A