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Status Epilepticus

Muhammad I. Durrani, MS, DO, Clifford M Chang, MD and Carla Dugas, DO, Reviewed 04/2024
 


BASICS

Status epilepticus (SE) is a neurologic emergency. Rapid seizure control is critical to minimize permanent neuronal injury. The manifestations of SE range from clinically silent to dramatic pre...

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. The initial goals are to stop the seizure, prevent complications, and addres...

ONGOING CARE

DIET

Limited evidence for the use of the ketogenic diet in super refractory SE. 

PATIENT EDUCATION

Reinforce compliance with anticonvulsant medications and alcohol cessation. 

PROGNOSIS

  • Progno...

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. Support airway and hemodynamics.

  • Immediately administer lorazepam IV or midazolam IM unless there is high clinical suspicion for another clearly reversible etiol...

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