Status epilepticus part II

While treating status epilepticus it if of crucial importance to eliminate its probable cause. Pharmacological treatment is also important on a par with ensuring protection of vital parameters and their observation.

In such cases, one ought to ensure appropriate airway patency of the respiratory system, for example by placing an oropharyngeal tube in the patient’s mouth. It may be also helpful to assume greater puncture and implement passive oxygen therapy.

Persons with status epilepticus should not take medicine orally, but rather intravenously and intramuscularly, rectally or intraosseously. It is also important to fight the effects of the physiological and metabolic crises such as hyperthermia, hypoglycemia, hypotension, hypoxia and lactic acidosis.

It is also recommended to perform baseline blood tests, an electroencephalogram, computed tomography, and during later stages – magnetic resonance. In the event of fever, lumbar puncture ought to be performed along with sampling of the cerebrospinal fluid – as the core for culture cultivation.

In the case of suspicion of a non-conclusive seizure, it may be necessary to make an electroencephalogram and administer diazepam or lorazepam. Laboratory tests can help detect their cause. The most common ones include: drug toxicity, electrolyte imbalance, non-ketotic hyperglycemia or focal brain damage. Patients with non-conclusive status epilepticus are often erroneously recognized and treated at psychiatric wards.

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