WHAT IS STATUS EPILEPTICUS?
A seizure involves abnormal electrical activity in the brain affecting both the mind and the body. Many problems can cause you to have a seizure. These include high fever, brain infections, abnormal sodium or blood sugar levels, or head injuries. If you have epilepsy, you may have seizures repeatedly.
A seizure that lasts longer than 5 minutes, or having more than 1 seizure within a 5 minutes period, without returning to a normal level of consciousness between episodes is called status epilepticus. This is a medical emergency that may lead to permanent brain damage or death.
Status Epilepticus Seizure
Status epilepticus is very rare, most people with epilepsy will never have it. This condition is more common in young children and elderly adults.
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.
WHAT CAUSES STATUS EPILEPTICUS?
It is not entirely clear what happens in the brain when a child has status epilepticus. Researchers know that it is a complex process that seems to be linked to a loss of inhibition mechanisms in the brain, poor blood flow, decreased use of glucose, and decreased oxygen consumption.
Convulsive status epilepticus may result from:
- Infection
- Sleep deprivation in a seizure-prone individual
- Fever
- Metabolic disorder
- Abruptly discontinuing anti-epileptic drugs
- Poorly controlled epilepsy, even without an obvious precipitating factor
- Alcohol or street drugs
- Some other chronic medical conditions
WHO IS AT RISK FOR STATUS EPILEPTICUS?
There are many risk factors for status epilepticus including:
- Poorly controlled epilepsy
- Low blood sugar
- Stroke
- Kidney failure
- Liver failure
- Encephalitis (swelling or inflammation of the brain)
- HIV
- Alcohol or drug abuse
- Genetic diseases such as Fragile X syndrome and Angelman syndrome
- Head injuries
WHAT ARE THE SYMPTOMS OF STATUS EPILEPTICUS?
These are possible symptoms of status epilepticus:
- Muscle spasms
- Falling
- Confusion
- Unusual noises
- Loss of bowel or bladder control
- Clenched teeth
- Irregular breathing
- Unusual behavior
- Difficulty speaking
- A "daydreaming" look
HOW IS STATUS EPILEPTICUS TREATED?
The healthcare provider will want to end the seizure as quickly as possible and treat any underlying problems that are causing it. You may receive oxygen, have blood tests, and an intravenous (IV) line. You may be given glucose (sugar) if low blood sugar may be causing the seizure.
Healthcare providers may use anti-seizure drugs to treat the problem, including:
- Diazepam
- Lorazepam
- Phenytoin
- Fosphenytoin
- Phenobarbital
- Valproate
- Levetiracetam
These drugs are given through an IV or an injection into a muscle.
WHAT ARE THE COMPLICATIONS OF STATUS EPILEPTICUS?
Complications depend on the underlying cause and can range from no complications to death. If the underlying cause, such as poor epilepsy control, can be fixed, there may no complications. If the underlying cause is a stroke or brain injury, complications may include physical disability from the cause or even death
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