Clinical Approach to Status Epilepticus

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Continuous occurrence of seizure in series is called as Status epilepticus. Abnormal prolonged Seizure lasts for more than 30 minutes without break. Any type of seizure may involve without recovery of consciousness. Seizure may result in death, injury to brain or damage to central nervous system. If seizure lasts for more than 5 minutes then call emergency service. Senior persons are more affected by status epilepticus than other persons.

Types of Status Epilepticus

Status epilepticus may be divided in two types which are as follows

1. Convulsive- It includes tonic-clonic, tonic, clonic or myoclonic seizures. It is responsible prolong damage (Oxygen inefficiency).
   
2. Non-convulsive-It includes absence or complex partial seizures. Loss of speech, alteration of consciousness, confusion and automatisms happen in non-convulsive type.

What are causes for Status epilepticus?

1. Abrupt withdrawal or insufficient dosage of anticonvulsant drugs
   
2. Brain tumors or head injury, craniocerebral trauma or cerebrovascular accidents.
   
3. Insufficient levels of glucose
   
4. Cocaine or other illegal drugs and intake of excessive alcohol
   
5. High fever
   
6. Toxic or metabolic disorders
   
7. Lack of sleep
   
8. Chances of status epilepticus increased when child has symptomatic epilepsy
   
9. Status epilepticus triggered within two years after the child’s epilepsy start.
   
10. If neurological examination shows abnormal results then there is chance of status epilepticus.

What are the symptoms for Status epilepticus?

• Seizure continues for more than 30 minutes
  
• Unable to regain consciousness during continuous seizures.
  
• Muscle contractions and jerking movements of body
  
• Difficulty in breathing
  
• Death, brain and central nervous system damage, pulmonary edema can occur if treatment is not given immediately.

How to get rid of Status epilepticus?

• Call doctor if seizure suffers for than 5 minutes.
  
• Lorazepam is better option for immediate control of status epilepticus
  
• For stopping seizures benzodiazepines, phenobarbital, fosphenytoin or phenytoin are given depending upon the type of seizure.
  
• Doctor will try to maintain body temperature and other important function.
  
• Oxygen is given if it is required. Small tube is inserted through nose or throat for good breathing.
  
• Rectal diazepam gel is given for home to control seizure.