Status Epilepticus

Status Epilepticus – General Information

Generally, Status Epilepticus is a condition that can be characterized by an increased and continuous seizure activity. In most cases, the seizures last less than four minutes; in the case that the patient experiences seizure for more than five to ten minutes, he can be considered to be suffering from this kind of medical condition and treated accordingly. Usually, almost all types of seizures can appear and develop in a continuous or repeated pattern. This kind of disease is classified in two major categories: generalized and focal, each differing depending on the clinical features of the type. The generalized form of Status Epilepticus is characterized by the presence of tonic, clinic, absence and myoclonic seizures. There are cases when, if a patient who suffers from the generalized form of the disease is not treated properly, he/she can develop a subtype of the condition called non convulsive form. This can manifest with sustained or repeated complex partial seizures that can cause changes in the patient’s mental status. The focal form of Status Epilepticus is characterized by limited physical signs but with alteration of consciousness. The disease can also appear in patients who also suffer from epilepsy.

It is very important for the doctor to treat the condition in its first stages of evolution, because it can decrease the rate of developing complications. If the disease is not treated properly or not treated at all, it can cause severe complications that can threat the life of the patient. For further information we advise you to contact a trained specialist.

Status Epilepticus – Symptoms

The exact evolution and manifestation of the patient’s seizures is very complex and not fully understood by all doctors. The most common signs and symptoms that the patient can experience appear as seizures. Status Epilepticus is a disease that can manifest differently depending on the patient’s age and organism; in young patients the disease can manifest as perinatal hypoxia and anoxia, which are characterized by low levels of oxygen or no oxygen at all. If these conditions are not treated properly, they can affect the patient’s brain. There are cases in which certain medical conditions can cause the disease to appear, and the most common disease that can be lead to seizures is Meningitis. There are also other metabolic disorders that can cause Status Epilepticus.

In adult patients, the condition can be cause by certain infections of the patient’s brain, by strokes, severe brain tumors, and chronic head trauma. Usually, a limited seizure, such as an arm jerking, can be a sign of focal form of the condition, especially if it takes place without consciousness. But if the symptom is continuous, the patient may be diagnosed with the generalized form of Status Epilepticus. The generalized type is usually more dangerous than the focal type because it can cause cardiac arrhythmias or blood pressure changes, conditions that can threat the life of the individual. There are cases in which the patient can also develop breathing and oxygenation problems which may require ventilator assistance and specialized medical attention at a hospital.

Status Epilepticus – Treatment

Status Epilepticus is a kind of disease that is easy to diagnose, due to the presence of prolonged seizures. Although, there are cases when the patient can present a more subtle form of the disease and may require an electroencephalogram or EEG to diagnose it. This kind of procedure is not only used as a diagnosing procedure, but it can also be used as a form to monitor the patient and his responses to the available treatment. An important factor in diagnosing Status Epilepticus is that its manifestations have to be discovered early so that the treatment can be efficiently applied. To do this, doctors have to perform several tests and examinations that can include testing blood for glucose, electrolytes, liver function and certain abnormal substances. If the patient presents low levels of glucose or extreme changes in the amounts of sodium, he is likely to experience seizures.

There are certain medicines that can be used to balance these levels, and can include Phenytoin, Phenobarbital, Carbamazepine and Valproic acid. If the patient presents a low level of anticonvulsant substance inside the organism, he is likely to develop epilepsy, one of the main causes of Status Epilepticus. The treatment for this kind of disease usually depends on the main cause, but also on the severity and period of evolution of the signs and symptoms. If the patient is suffering from hypoglycemia, the main medicine that has to be immediately administered is Thiamine, a drug that can also be used as a glucose supplement. Due to this fact, some patients, especially alcoholics, present a low level of Thiamine inside the blood, and require supplementation. If these cases are not treated properly, Status Epilepticus can evolve causing a disease called Wernicke’s encephalopathy. In most cases, doctors can perform a computerized tomography or CT to determine if the patient presents any brain trauma, or suffers from other brain diseases such as Meningitis. Some doctors choose to administer antibiotics to control the condition for any further treatment and examination.

If the patient presents a severe manifestation of the specific signs and symptoms, the first treatment option is to administer Lorazepan and Diazepam as sedatives, to stop certain seizures. This operation is done until the health care provider applies the available anticonvulsant treatment that can include Phenytoin. There are cases when the patient’s symptoms still persist despite the administration of anticonvulsant; then the doctor can use another medicine called Phenobarbital to control the patient’s medical status. It is very important the doctor examines the patient before administering the medicine, because if it is not used properly it can cause certain complications such as respiratory depression. In treating Status Epilepticus, it is very important to perform repeatedly an electroencephalogram to monitor the patient’s response to medication. There are certain medicines that can also be used as backup if Phenobarbital fails to act, and can include Midazolam, or Propofol.