17B. Status epilepticus

Definition

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.

Treatment

  • 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

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17A. Types and etiology of unconsciousness. Coma

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18A. Migraine and other primary headaches

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