Status epilepticus

Question 1

What is status epilepticus?

Answer 1

Seizure lasting >30 minutes or 2 seizures without return to baseline between them
treat seizure after 5 minutes

Question 2

What are the types of status epilepticus?

Answer 2

Simple partial (epilepsia partialis continua)
Complex partial
Generalized tonic clonic
Absence
Myoclonic
Subclinical status epilepticus

Question 3

What are the most common causes of status eptulepticus that causes death?

Answer 3

anoxia
hypo
acute stroke

Question 4

what are early identification of status eptilipticus?

Answer 4

Simple partial and generalized tonic-clonic generally easier to identify

Complex partial, absence and subclinical status epilepticus more difficult

Consider in patients with decreased level of consciousness
Cues may include
Gaze preference
Blinking
Automatisms
Posturing
No clear cause for decreased LOC

Urgent EEG diagnostic

Question 5

What is step 1 (0-5 minutes) of status epilepticus?

Answer 5

give oxygen, asses airway and apply pulse ox

Question 6

What is step 2 (6-10 min)?

Answer 6

administer thalami and dextrose

give IV of lorazepam at 0.1 mg/kg

Question 7

What is step 3 (11-30 min)

Answer 7

Give IV fosphenytoin

if seizures persist give max dose of fosphenytoin or phenytoin

Question 8

What is step 4 (31-50 min)?

Answer 8

intubate pt if seizure persist

Question 9

What is step 5?

Answer 9

order urgent EEG