5. Treatment of status epilepticus

Page created on February 8, 2022. Last updated on December 18, 2024 at 16:58

Definition

Status epilepticus is defined as either:

Ongoing seizure activity (> 30 minutes)
Repetitive seizures for greater than 30 minutes without recovery of consciousness in between

However, because of poor prognosis, treatment is initiated if the seizure persists for more than 5 minutes (we don’t wait for 30 minutes).

Etiology

Drug intoxication
Drug withdrawal
Hypoglycaemia
Electrolyte imbalance
Head trauma
Infection
Ischaemic stroke
Intracranial haemorrhage
Metabolic disorders
Hypoxia
Epilepsy

Treatment of status epilepticus

0^th step: ABC
1^st step: Benzodiazepine
- If vascular access: IV 0,2 – 0,5 mg/kg diazepam (or midazolam or lorazepam)
- If not: i.m. midazolam or buccal midazolam or rectal diazepam
2^nd step: Repeat benzo doze
3^rd step: Antiepileptic
- Phenytoin or fosphenytoin or levetiracetam or valproate or phenobarbital
4^th step: General anaesthesia

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4. Differential diagnosis of convulsions in children and neonates.

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8. Shock. Types, symptoms, differential diagnosis

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Paediatrics