Status epilepticus
This disorder is characterized by continuous or repetitive seizures, lasting 15-30 minutes and an altered state of consciousness in interictala.
Status epilepticus is always an emergency crises often occur as a result of cardiovascular disorders, hyperthermia, metabolic imbalances that can lead to irreversible neuronal damage.
Causes The most common causes include withdrawal from anticonvulsants, metabolic imbalances, drug toxicity, infection and central nervous system tumors, cranio-cerebral trauma, refractory epilepsy.
Clinical Patients have convulsions lasting over 30 minutes, may have only mild clonic movements of the fingers or rapid eye movements. Seizures may accompany or continuous episodes of paroxysmal tachycardia, hypertension, pupillary dilatation.
Diagnosis The best method of diagnosis is conducting an EEG.
Treatment Patient came mostly in emergency and establishing an intravenous line, to solve problems and acute cardiorespiratory hyperthermia is performed quickly and neurological medical examination, laboratory blood are collected and sent to the intensive care unit where treatment is applied anticonvulsant.
Anticonvulsant treatment begins with lorazepam 0075 mg / kg iv to 2 mg / min phenytoin 20 mg / kg i.v. If seizures are not inferior to phenytoin and phenobarbital therapy continues and may even go up from sedation with barbiturates or benzodiazepines.
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