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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.
[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.
Status epilepticus is a seizure "lasting longer than 30 minutes or a series of seizures without return to the baseline level of alertness between seizures." [ 12 ] Epilepsia partialis continua is a rare type of focal motor seizure, commonly involving the hands or face , which recurs with intervals of seconds or minutes, lasting for extended ...
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.
[3] [8] If a seizure lasts longer than 5 minutes, it is a medical emergency (status epilepticus) and needs immediate treatment. [3] [5] [9] Seizures can be classified as provoked or unprovoked. [3] [6] Provoked seizures have a cause that can be fixed, such as low blood sugar, alcohol withdrawal, high fever, recent stroke, and recent head trauma.
Psychogenic non-epileptic seizures (PNES), also referred to as pseudoseizures, non-epileptic attack disorder (NEAD), functional seizures, or dissociative seizures, [2] [3] are episodes resembling an epileptic seizure but without the characteristic electrical discharges associated 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 ...
In particular, the GABA agonists vigabatrin and tiagabine are used to induce, not to treat, absence seizures and absence status epilepticus. [30] Similarly, oxcarbazepine, phenytoin, phenobarbital, gabapentin, and pregabalin should not be used in the treatment of absence seizures because these medications may worsen absence seizures. [26]