How is status epilepticus (SE) managed?
Absence status epilepticus is much less likely to result in neuronal injury, and complications because it may be mediated primarily through excess inhibition. Future research strategies to prevent complications of status epilepticus include the study of new drugs (including NMDA antagonists, new drug delivery systems, and drug combinations) to stop seizure activity and …
What is the pathophysiology of status epilepticus?
Aug 01, 2021 · Some in vitro models show that permanent neurological damage can set in after 30 minutes of status epilepticus. About 40 percent of patients with the first episode of status epilepticus develop subsequent epilepsy, and there is a 25 to 30 percent risk of recurrent status epilepticus after the first episode.
What are the complications of status epilepticus?
Oct 21, 2021 · Finally, there is a group of patients who are hospitalized in the ICU due to active or impending status epilepticus (SE). These patients may initially present with obvious convulsive activity, but with time convert to a state of electro-mechanical dissociation, with seizures only evident on EEG.
What is the prevalence of status epilepticus (SE)?
Mar 10, 2022 · INTRODUCTION. —. Status epilepticus is a medical and neurologic emergency that requires prompt evaluation and treatment. The rapid evaluation and treatment of convulsive status epilepticus is discussed below. The definition, classification, clinical features, and diagnosis of convulsive status epilepticus in adults are reviewed separately.
What happens if status epilepticus is not treated?
Status epilepticus (SE) is considered a neurological emergency. Left untreated (or undertreated), prolonged seizures can cause permanent neurological injury or death. Rapid treatment must be initiated. If initial agents fail, it may be necessary to induce an iatrogenic coma.
What complications may occur as a result of status epilepticus?
Acute complications result from hyperthermia, pulmonary edema, cardiac arrhythmias, and cardiovascular collapse. Long-term complications include epilepsy (20% to 40%), encephalopathy (6% to 15%), and focal neurologic deficits (9% to 11%).
What are some of the common long term effects of status epilepticus?
1, 2, 3, 4 Long‐term sequelae may include neurological, cognitive, and behavioral impairments and decline in quality of life (QoL),4, 5 and impose heavy burdens on the patient, the caregivers, and the healthcare system. Outcomes are influenced by type of epilepsy, type of SE, etiology, SE duration, and patient's age.Aug 26, 2018
What can status epilepticus cause?
Status epilepticus is a medical emergency. It can cause death due to physical injury, choking, or as a result of the seizure itself. The episode may cause lasting brain damage, which can result in worsening seizures, increased predisposition to status epilepticus, and cognitive decline.Nov 30, 2019
Who is at risk of status epilepticus?
The incidence in the US is about 41 or more per 100 000 population. The recurrence rate is about 13% Infants below the age of one year and the elderly who are above 60 years are at highest risk of SE. 40% occur below the age of 2 years.Feb 27, 2019
What is status epilepticus and what is the treatment?
The treatment of status epilepticus involves the use of potent intravenous medications that may have serious adverse effects. Therefore, the first step in managing the condition is to ascertain that the patient has tonic-clonic status epilepticus, and that prolonged or repetitive seizures have occurred.Aug 1, 2003
How do you rule out status epilepticus?
You may have status epilepticus if you have a seizure that lasts longer than 5 minutes, or if you have more than 1 seizure within a 5-minute period, without returning to a normal level of consciousness between episodes. This is a medical emergency.
What is the prognosis for status epilepticus?
Status epilepticus associated with causes such as low AED levels and alcohol abuse have a relatively good prognosis, with reported mortality in the case series of less than 10%, whereas causes such as metabolic disorders, cerebrovascular disease, and, particularly, anoxia/hypoxia are associated with much poorer ...Aug 9, 2010
When is status epilepticus defined as refractory?
Refractory status epilepticus is defined as persistent seizures despite appropriate use of two intravenous medications, one of which is a benzodiazepine. It can be seen in up to 40% of cases of status epilepticus with an acute symptomatic etiology as the most likely cause.May 8, 2018
What happens to the brain during status epilepticus?
Human status epilepticus (SE) is consistently associated with cognitive problems, and with widespread neuronal necrosis in hippocampus and other brain regions. In animal models, convulsive SE causes extensive neuronal necrosis.
Why is status epilepticus considered a medical emergency?
Status epilepticus (SE) is a medical emergency that starts when a seizure that lasts longer than expected, usually considered around 5 minutes (or if there's more than one seizure thta doesn't return to baseline).Mar 6, 2021
What is the most common cause of status epilepticus in pediatric patients?
Results: The most common cause of status epilepticus is febrile illness in children younger than 2 years and idiopathic/cryptogenic and remote symptomatic causes in children older than 2 years.
What is the name of the medication used for epilepsy?
Medications commonly used in the treatment of epilepsy include: Phenobarbital. A type of seizure MOST common in children is characterized by a blank stare only lasting a few seconds. This type of seizure is called a/an: Absence seizure. Febrile seizures are generally seen in children between the ages of:
What is the sensation of a seizure?
This sensation is known as a/an: Aura. To prevent additional injuries during repeated seizures, you should: Move objects from around the patient.
Case Objectives
Know that failure to properly act on abnormal test results is a significant patient safety issue.
The Case
A 21-year-old woman presented to the emergency department (ED) with heavy vaginal bleeding. She was admitted to the obstetrics and gynecology (OB/GYN) service for management. She received a blood transfusion and a Depo-Provera injection (a hormone to stop the bleeding), and was discharged home the next day.
The Commentary
The process of arriving at an accurate diagnosis often involves many steps in a complex system, and errors can occur at any step along the way.
Table
Table. Steps organizations can take to reduce the malpractice risk associated with following up test results.
