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Status epilepticus is a life-threatening medical emergency, particularly if treatment is delayed. [1] Status epilepticus may occur in those with a history of epilepsy as well as those with an underlying problem of the brain. [2] These underlying brain problems may include trauma, infections, or strokes, among others.
As is the case with other non-convulsive status epilepticus forms, CPSE is dangerously underdiagnosed. [3] This is due to the potentially fatal yet veiled nature of the symptoms. Usually, an electroencephalogram, or EEG, is needed to confirm a neurologist's suspicions.
The following benzodiazepines are used to treat status epilepticus: Diazepam (1963). Can be given rectally by trained care-givers. Midazolam (N/A). Increasingly being used as an alternative to diazepam. This water-soluble drug is squirted into the side of the mouth but not swallowed. It is rapidly absorbed by the buccal mucosa. Lorazepam (1972 ...
[4] Convulsive or non-convulsive seizures can occur in someone who does not have epilepsy – as a consequence of head injury, drug overdose, toxins, eclampsia or febrile convulsions. A provoked (or an un-provoked, or an idiopathic) seizure must generally occur twice before a person is diagnosed with epilepsy.
Convulsive status epilepticus that does not respond to initial treatment typically requires admission to the intensive care unit and treatment with stronger agents such as midazolam infusion, ketamine, thiopentone or propofol. [106] Most institutions have a preferred pathway or protocol to be used in a seizure emergency like status epilepticus ...
Clonazepam is mainly prescribed for the acute management of epilepsy. Clonazepam is effective in the acute control of non-convulsive status epilepticus; the benefits, though, tended to be transient in many people, and the addition of phenytoin for lasting control was required in these patients. [27]
Early electroencephalography is recommended if there is a possibility of non-convulsive or subtle status epilepticus. They are examined for disorders such as sarcoidosis , porphyria , and other unusual systemic disorders.
Carbamazepine, vigabatrin, and tiagabine are contraindicated in the treatment of absence seizures, irrespective of cause and severity. This is based on clinical and experimental evidence. [10] In particular, the GABA agonists vigabatrin and tiagabine are used to induce, not to treat, absence seizures and absence status epilepticus. [30]
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