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Chapter 39 - Status epilepticus

from Section III: - Organ dysfunction and management

Published online by Cambridge University Press:  06 July 2010

By
Joyce Yeung
Edited by
Fang Gao Smith
Edited in association with
Joyce Yeung
Fang Gao Smith
Affiliation:
University of Warwick
Joyce Yeung
Affiliation:
West Midlands Deanery
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Summary

Status epilepticus is classified into generalized convulsive status epilepticus (GCSE) and non-convulsive status epilepticus. This chapter discusses the aetiology of status epilepticus and pathophysiology of GCSE. It lists out different drugs such as benzodiazepines, diazepam, lorazepam, midazolam, phenytoin, fosphenytoin, phenobarbitone, thiopentone and popofol for terminating seizure activity. Refractory status epilepticus patients require intubation and ventilation and possibly pressor support in a critical care setting. Long-term and maintenance anti-epileptic drug (AED) therapy must be given in tandem with emergency treatment. The prognosis of patients with status epilepticus is related to the aetiology, age, duration of seizures and prompt initiation of treatment. Young patients whose status epilepticus was caused by low AED levels or systemic infection have very low mortality. In contrast, status epilepticus caused by cerebrovascular accident in the elderly has mortality of 35% and that associated with anoxic injury is usually fatal.

Keywords

alveolar hyperventilationhyperventilation syndromemetabolic acidosisrespiratory neuromuscular disorderprimary alveolar hypoventilationobesity hypoventilation syndromePaCO2
Type
Chapter
Information
Core Topics in Critical Care Medicine , pp. 306 - 311
Publisher: Cambridge University Press
Print publication year: 2010

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