Status Epilepticus

Status Epilepticus

A seizure involves abnormal electrical activity in the brain that affects the mind and body. Many problems can cause you to have a seizure. These include high fever, abnormal levels of sodium or blood sugar, and head injuries. If you have a condition called epilepsy, you may have seizures repeatedly.

A seizure that lasts at least 30 minutes is called status epilepticus, or a prolonged seizure. This is a medical emergency that may lead to permanent brain damage or death. Many medical experts become concerned that a seizure is status epilepticus after it lasts five to 10 minutes.

Facts about status epilepticus

This condition is especially common in young children and elderly adults.

Most people who experience status epilepticus don't have epilepsy; only about 25 percent do. Another way to look at it is that only about 15 percent of people with epilepsy will have status epilepticus during their life.

In children, the main cause of status epilepticus is an infection with a fever. In adults, these are common causes of the problem:

  • Stroke

  • Imbalance of substances in the blood, such as low blood sugar

  • Drinking too much alcohol or having alcohol withdrawal after previous heavy alcohol use

Types of status epilepticus

This condition can occur as:

  • Convulsive status epilepticus. Status epilepticus with convulsions may be more likely to lead to long-term injury. Convulsions may involve jerking motions, grunting sounds, drooling, and rapid eye movements.

  • Nonconvulsive status epilepticus. People with this type may appear confused or look like they're daydreaming. They may be unable to speak and may be behaving in an irrational way.

Symptoms

These are possible symptoms of status epilepticus:

  • A seizure that lasts more than five minutes, or more than one seizure in a row without regaining consciousness in between

  • Muscle spasms

  • Falling

  • Confusion

  • Unusual noises

  • Loss of bowel or bladder control

  • Clenched teeth

  • Irregular breathing

  • Unusual behavior

  • Difficulty speaking

  • A "daydreaming" look

Diagnosis

Your doctor will probably diagnose this problem by carefully examining you and asking whether you have epilepsy or other health problems. The doctor may also ask about any medication you’re taking and if you’ve been using alcohol or other recreational drugs

Your doctor may also order an electroencephalogram. A health care provider will place painless electrodes onto your scalp. These measure the brain's electrical activity.

You may need other tests to search for possible causes. These include a lumbar puncture, or spinal tap, to look for signs of infection. A CT scan or MRI may be needed to see problems in the brain.

Treatment

The doctor will want to end the seizure as quickly as possible and treat any underlying problems that are causing it. The doctor may give you oxygen, take blood samples, and put an intravenous (IV) line into a vein. You may be given glucose (sugar) if low blood sugar may be causing the seizure.

Doctors may use anti-seizure drugs to treat the problem, including:

  • Diazepam

  • Lorazepam

  • Phenytoin

  • Fosphenytoin

  • Phenobarbital

  • Valproate

These drugs are given through an IV or an injection into a muscle.

Prevention

If you have epilepsy, taking your medications as directed may help you avoid status epilepticus. If you’ve had status epilepticus, you may need to begin taking seizure medicines or change medications you’re already taking. Avoiding other causes of this condition, such as alcohol abuse or low blood sugar, may also help prevent it.

Managing status epilepticus

This is an emergency that requires immediate medical care.

 
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