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Diagnosis. Status epilepticus Continuous clinical or EEG seizures lasting atleast 30 minutes or recurrent seizures without return of consciousness during interictal period; the series lasting for 30 minutes or more. Pertinent History. H istory of infections, including meningitis
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Diagnosis Status epilepticus • Continuous clinical or EEG seizures lasting atleast 30 minutes or recurrent seizures without return of consciousness during interictal period; the series lasting for 30 minutes or more
Pertinent History • History of infections, including meningitis • Any history of previous seizures • Compliance to anticonvulsant drugs/ abrupt withdrawal • Drug use (INH) or exposure to toxins • Anoxia • Vascular disturbances • Metabolic disturbances ( electrolyte abnormalities)
Pertinent History • History of static encephalopathies • Cerebral palsy • Head trauma • Underlying chronic illness
Physical & Neurologic Examination • Vital signs • Observation of seizure activity • Skin bruises, petechiae or needle marks • Papilledema and retinal hemorrhage • Organomegaly and abdominal tenderness
Diagnostic Tests • Determine the cause of the seizure • Blood glucose level • Toxic scree • CBC • Electrolytes including Ca • BUN • Anticonvulsant drug level • ABG • Bacterial and viral cultures • EEG • CT/MRI • CSF determination
Classification of status epilepticus 1. Overt generalized convulsive status epilepticus- continuous convulsive activity and intermittent convulsive activity without regaining full consciousness • Convulsive (tonic-clonic) • Tonic • Clonic • Myoclonic
Classification of status epilepticus 2. Subtle generalized convulsive status epilepticus • Coma following generalized convulsive status epilepticus with or w/o motor activity 3. Simple status epilepticus • Consciousness preserved • Simple motor status epilepticus • Sensory status epilepticus • Aphasic status epilepticus
Classification of status epilepticus 4. Non convulsive status epilepticus • Consciousness impaired; twilight or fugue state • Petit mal seizures (absence seizure) • Complex partial status epilepticus