Status Epilepticus

Question 1

What is status epilepticus?

Answer 1

Means continuous seizures for 30minutes or longer or two or more seizures without recovery of consciousness between them over a similar period

Question 2

What is the management of status epilepticus?

Answer 2

Early Status:
1. A-E assessment 
> airway adjunct
>oxygen
>check blood glucose
>anaesthetist

2. Benzodiazepine such as diazepam or lorazepam given
   >IV 4mg bolus lorazepam in hospital
   >repeat once if necessary
   >alternative midazolam buccal

Established Status:
3. Ongoing status start 2nd line agents:
>1st: phenytoin 15mg/kg or fosphenytoin
>2nd: Phenobarbital 10mg/kg IV

4. Refractory status >45mins consider inducing general anaesthesia in ICU setting

Question 3

What is the time frame of early status?

Answer 3

Seizing time up to 30minutes

Question 4

What is the time frame of established status?

Answer 4

30-90mins

Question 5

What is refractory status?

Answer 5

*Some say over 45mins some say over 90mins