Status epilepticus

Status epilepticus (SE) is a single epileptic seizure lasting more than five minutes or two or more seizures within a five-minute period without the person returning to normal between them.

Any seizure lasting longer than 5 minutes should be treated as status epilepticus.

Benzodiazepines are the preferred initial treatment after which typically phenytoin is given. Benzodiazepines are the preferred initial treatment after which typically phenytoin or fosphenytoin is given.

The intravenous form is used for status epilepticus that does not improve with benzodiazepines.

Possible benzodiazepines include intravenous lorazepam as well as intramuscular injections of midazolam.

It is used to treat anxiety disorders, trouble sleeping, active seizures including status epilepticus, alcohol withdrawal, and chemotherapy-induced nausea and vomiting.

A number of other medications may be used if these are not effective such as valproic acid, phenobarbital, propofol, or ketamine.

The injectable form may be used to treat status epilepticus.

A number of other medications may be used if these are not effective such as valproic acid, phenobarbital, propofol, or ketamine.

It is also used for status epilepticus if other medications have not worked.

Possible benzodiazepines include intravenous lorazepam as well as intramuscular injections of midazolam.

Midazolam is effective for status epilepticus that has not improved following other treatments or when intravenous access cannot be obtained, and has advantages of being water-soluble, having a rapid onset of action and not causing metabolic acidosis from the propylene glycol vehicle, which occurs with other benzodiazepines.

Status epilepticus may occur in those with a history of epilepsy as well as those with an underlying problem of the brain.

If a seizure lasts longer than 5 minutes or if there are more than two seizures in an hour without a return to a normal level of consciousness between them, it is considered a medical emergency known as status epilepticus.

In the case of complex partial status epilepticus, the seizure is confined to a small area of the brain, normally the temporal lobe.

Complex partial status epilepticus (CPSE) is one of the non-convulsive forms of status epilepticus, a rare form of epilepsy defined by its recurrent nature.

The seizures can be of the tonic–clonic type, with a regular pattern of contraction and extension of the arms and legs, or of types that do not involve contractions, such as absence seizures or complex partial seizures.

Other general actions to take as recommended by the Epilepsy Foundation include: staying with a person until a seizure is over, paying attention to length of seizure as a possible indication for status epilepticus and/or indication to give rescue medication and call for emergency help, moving close objects out of the way to prevent injury.

The seizures can be of the tonic–clonic type, with a regular pattern of contraction and extension of the arms and legs, or of types that do not involve contractions, such as absence seizures or complex partial seizures.

In particular, the GABA agonists vigabatrin and tiagabine are used to induce, not to treat, absence seizures and absence status epilepticus.

It is still used to treat status epilepticus, particularly where there are no resuscitation facilities.

Benzodiazepines are the preferred initial treatment after which typically phenytoin or fosphenytoin is given.

It is most commonly used in the acute treatment of convulsive status epilepticus.

In several countries outside North America, intravenous clonazepam is regarded as the drug of first choice.

Clonazepam has been found to be effective in the acute control of non-convulsive status epilepticus; however, the benefits tended to be transient in many people, and the addition of phenytoin for lasting control was required in these patients.

Benzodiazepines are the preferred initial treatment after which typically phenytoin is given. Benzodiazepines are the preferred initial treatment after which typically phenytoin or fosphenytoin is given.

As in humans, they are used in the first-line management of seizures, status epilepticus, and tetanus, and as maintenance therapy in epilepsy (in particular, in cats).

A number of other medications may be used if these are not effective such as valproic acid, phenobarbital, propofol, or ketamine.

It has also been successfully given intravenously to treat status epilepticus.

It is a consequence of vascular disease, tumors, or encephalitis, and is drug-resistant.

Identification of poor prognostic factors include cerebral edema, status epilepticus, and thrombocytopenia.

Thiopental or pentobarbital may also be used for that purpose if the seizures have to be stopped immediately or if the person has already been compromised by the underlying illness or toxic/metabolic-induced seizures; however, in those situations, thiopental is the agent of choice.

In refractory status epilepticus, thiopental may be used to terminate a seizure.

Thiopental or pentobarbital may also be used for that purpose if the seizures have to be stopped immediately or if the person has already been compromised by the underlying illness or toxic/metabolic-induced seizures; however, in those situations, thiopental is the agent of choice.

This is considerably higher than the dose for the management of status epilepticus.

Allopregnanolone is being studied in a clinical trial by the Mayo Clinic to treat super-resistant status epilepticus.

Brexanolone was under development as an intravenously administered medication for the treatment of major depressive disorder, super-refractory status epilepticus, and essential tremor, but development for these indications was discontinued.

Status epilepticus may occur in those with a history of epilepsy as well as those with an underlying problem of the brain.

These underlying brain problems may include trauma, infections, or strokes among others.

Diagnosis often involves checking the blood sugar, imaging of the head, a number of blood tests, and an electroencephalogram.

Diagnosis often involves checking the blood sugar, imaging of the head, a number of blood tests, and an electroencephalogram.

Psychogenic nonepileptic seizures may present similarly.

Other conditions that may also appear to be SE include low blood sugar, movement disorders, meningitis, and delirium among others.