Status; Epilepticus

Epilepticus: What is Status epilepticus?

Status epilepticus is a life-threatening condition that is marked by a prolonged seizure or seizures without a period of recovery, affecting 1 to 3 per 10,000 people. It requires urgent medical intervention to stop the seizure and prevent complications. Seizures that last longer than five minutes, or two or more seizures that occur without a period of recovery, are defined as status epilepticus and can be divided into convulsive and non-convulsive seizures.

Types of Status Epilepticus

The two main types of status epilepticus are convulsive and non-convulsive. Convulsive status epilepticus involves visible seizure activity and includes other forms of seizures, such as clonic, tonic, and tonic-clonic. Non-convulsive status epilepticus occurs without visible seizure activity and can include absence, myoclonic, and atonic seizures. Both types can recur.

Symptoms of Status Epilepticus

The symptoms of convulsive status epilepticus can include:

  • uncontrollable (involuntary) movements
  • confusion or disorientation
  • loss of consciousness
  • difficulty breathing
  • prolonged jerking or twitching of muscles
  • staring spells

The symptoms of non-convulsive status epilepticus can include:

  • confusion, disorientation, or delirium
  • abnormal movements, such as eye blinking
  • headaches
  • changes in behavior, such as agitation, aggression, violent behavior, or unresponsiveness

Causes of Status Epilepticus

Status epilepticus can be caused by an underlying disorder, such as brain tumors, cerebrovascular diseases, infections, metabolic diseases, and trauma. It can also be caused by drug or alcohol withdrawal, an overdose, or changes in antiepileptic medication.

Diagnosis of Status Epilepticus

Status epilepticus can be diagnosed based on the patient's history and a physical exam. The doctor may review blood work, brain imaging scans, and an electroencephalogram (EEG) to look for abnormalities in the electrical activity in the brain. Additionally, the doctor may order an lumbar puncture to look for any signs of meningitis, a serious infection of the lining of the brain.

Treatment of Status Epilepticus

Treatment for status epilepticus focuses on stopping the seizure and preventing further complications. The doctor may administer medication, such as benzodiazepines, to stop the seizure and may also provide supportive care, such as supplemental oxygen and intravenous fluids. If the seizure persists, the doctor may administer stronger medication or provide anesthesia and a breathing tube. In rare cases, a doctor may recommend surgery to treat an underlying condition that is causing the seizures.

Complications of Status Epilepticus

Complications of status epilepticus can include permanent damage to the brain, as well as other organs such as the heart or lungs. Status epilepticus can also be fatal. Long-term complications can include difficulty with memory, communication, and behavior.