Status epilepticus is defined as either a single epileptic seizure lasting longer than 5 minutes, or more than one seizure without recovery of consciousness in-between. It’s more commonly a result of symptomatic seizure rather than epilepsy.
It’s a life-threatening condition with high mortality, as cerebral oedema, aspiration, shock, rhabdomyolysis, etc. may occur.
- Ensure stability (ABC)
- 1 ampulla IV lorazepam or other BZD
- Alternative if no IV access: IM or buccal or rectal midazolam
- If no response within 1 minute -> give another dose
- If no resolution after 2 doses of BZD = refractory status epilepticus
- Give IV valproate or levetiracetam
- If antiepileptics does not work, give narcosis with propofol or midazolam infusion
- Treat underlying cause
17A. Types and etiology of unconsciousness. Coma
18A. Migraine and other primary headaches