Status Epilepticus

Question 1

What is status epilepticus?

Answer 1

recurrent epileptic seizures without full recovery on consciousness - lasts >30 mins

Question 2

What are the different types of status epilepticus?

Answer 2

generalised convulsive status epileptics
non convulsive status - concious but in an altered state
epilepsia partialis continua - continued focal seizures but conciousness preserved

Question 3

What is the pathophysiology behind status epilepticus?

Answer 3

generalisec onvulsions without cessation

excess cerebral energy demand (lots of glutamate released) and poor substance delivery -> lasting damage

Question 4

What can occur as a consequence of status epilepticus?

Answer 4

respiratory insufficiecy and hypoxia
hypotension
hyperthermia
rhabdomyolysis

Question 5

What can precipitate status epilepticus?

Answer 5

severe metabolic disorders 
infection
head trauma
sub arachnoid haemorrhage
treating absence seizures with carbimazole
abrupt withdrawl of anticonvulsants

Question 6

How is status epilepticus managed acutely?

Answer 6

stabalise patient - ABC
blood tests + CT to identify cause
Antiepileptics for immediate control - lorazepam IV or diazepam IV

Question 7

How is status epilepticus managed for sustained control?

Answer 7

if established epilepsy - continue epileptic drugs
if coninuing seizures:
Fosphenytoin IV with ECG monitoring
Phenytoin IV with ECG monitoring
Phenobarbitals IV

Question 8

How is status epilepticus confirmed?

Answer 8

EEG reading