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Status Epilepticus

Muhammad I. Durrani, MS, DO, Carla Dugas, DO and Justin Chu, DO Reviewed 06/2022
 


BASICS

ALERT

The various forms of status epilepticus (SE) constitute a spectrum of neurologic emergencies associated with significant morbidity and mortality. Prompt diagnosis and rapid seizure control...

DIAGNOSIS

HISTORY

  • Convulsive SE is a clinical diagnosis, commonly presenting with sustained tonic–clonic motor activity.

    • Convulsions begin with tonic stiffening typically, which may be generalized or fo...

TREATMENT

The most important element of successful termination of seizures is the time elapsed before initiating treatment. Simultaneous goals are to stop the seizure, find the cause, and prevent comp...

ONGOING CARE

PATIENT EDUCATION

Reinforce importance of continuing anticonvulsant medications and avoiding alcohol. 

PROGNOSIS

  • Prognosis is largely dependent on the etiology of SE with poor prognoses asso...

REFERENCES

1
Glauser  T, Shinnar  S, Gloss  D, et al. Evidence-based guideline: treatment of convulsive status epilepticus in children and adults: report of the guideline commit...

SEE ALSO

Seizure Disorders; Seizures, Febrile 

CODES

ICD10

  • G40.901 Epilepsy, unsp, not intractable, with status epilepticus

  • G40.401 Oth generalized epilepsy, not intractable, w stat epi

  • G40.411 Oth generalized epilepsy, intractable, w status epilepti...

CLINICAL PEARLS

  • SE is life-threatening; begin treatment immediately even before etiology is known and start with IV lorazepam or IM midazolam and add antiepileptic urgently.

  • If not controlled with firs...

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