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Call Us+91 92688 80303A seizure that extends longer than 5 minutes, or having more than one seizure within 5 minutes, without returning to an average level of consciousness between episodes, is called status epilepticus. This medical emergency may lead to permanent brain damage or death.
Status epilepticus occurs when seizures last too long or are close together, and the person doesn't recover between seizures.
Very long seizures are dangerous and even increase the chance of death and permanent brain injury. These prolonged seizures must be identified early to be treated early.
Status epilepticus presents in two forms:
This term describes the common form of an emergency that occurs with prolonged or repeated tonic-clonic (also called convulsive or grand mal) seizures. Most tonic-clonic seizures typically end in 1 to 2 minutes but may have post-ictal or after-effects symptoms for an extended period. This makes it difficult to assess the start or end of the seizure.
Status epilepticus with convulsions is more likely to lead to long-term injury. Seizures may involve jerking motions, grunting sounds, drooling, and rapid eye movements.
This describes the long or repeated absence or focal impaired awareness (complex partial) seizures.
People with nonconvulsive status epilepticus may look like they are daydreaming or appear confused. They may be unable to speak and maybe behave in an irrational way.
When nonconvulsive status epilepticus occurs, emergency medical treatment in a hospital setting is needed. EEG testing may be necessary to confirm the diagnosis first. People with this status are also at risk for convulsive status epilepticus. Thus, quick treatment is required.
These are possible symptoms of status epilepticus:
Falling
Confusion
Unusual noises
Loss of bowel or bladder control
Clenched teeth
Irregular breathing
Unusual behaviour
Difficulty speaking
A "daydreaming" look
Continuous jerks in head/limbs/face
The main cause of status epilepticus in children is infections with fevers. In adults, common causes include:
Conditions such as low blood sugar or low sodium
Excessive alcohol consumption or alcohol withdrawal after previous heavy alcohol use
Head injury
Brain infection/septicemia
Kidney/Liver failure
Doctors may advise the following tests to diagnose status epilepticus:
Other possible tests include:
It can be challenging to diagnose nonconvulsive status epilepticus because it may be mistaken for other conditions, such as psychosis and drug intoxication.
Treatment for status epilepticus can be done at home or at the hospital, depending on the patient's condition.
If a person is having seizures at home, the accompanying person must:
Call an ambulance for a patient who has any seizure if:
First-line of treatment in the hospital consists of:
Complications of status epilepticus depend on the underlying cause and range from no complications to death. There may be no complications if the underlying cause can be fixed. If the underlying cause is stroke, poor epilepsy control, or brain injury, complications may include physical disability or death.
Many risk factors are associated with status epilepticus. These include:
Status epilepticus has a variable prognosis. In large hospital-based studies, the mortality rate varies from 3% to 50%. The factors associated with high mortality include
Cardiovascular decompensation during SE, medical complications, and overtreatment with AEDs may also predispose to excess mortality. Coma with recurrent electrographic status and multiorgan dysfunction carry poor clinical outcomes.
Reviewed by Dr. Amit Batra, Principal Consultant, Neurosciences, Neurology on 27-Mar-2023.
Max Healthcare is home to 5000 eminent doctors in the world, most of whom are pioneers in their respective fields. Additionally, they are renowned for developing innovative and revolutionary clinical procedures.
Max Healthcare is home to 5000 eminent doctors in the world, most of whom are pioneers in their respective fields. Additionally, they are renowned for developing innovative and revolutionary clinical procedures.
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