| ID | 119 |
|---|---|
| Name | STATUS EPILEPTICUS |
| Cause | |
| Signs Symptoms | |
| Diagnosis | |
| Investigations | |
| Management | |
| Introduction | Status epilepticus refers to a continuous succession of fits occuring without any period of, recovery. It is commoner in childhood & in patients who have intracranial lesions. |
| History | |
| Etiology | |
| Clinical Features | |
| Preventions | |
| Treatment | Treatment: Treatment should be prompt and energetic. 1. Adequate respiration must be maintained- give high flow O2. 2. Inj. diazepam- initially 10-20mg by i.v injection and then repeat once only after 15 minutes or lorazepam 4mg i.v if the fits are not controlled. 3. Patient should be transferred to the hospital with intensive care arrangement, if available. 4. Then start anticonvulsant drug- Phenytoin, a loading dose of 15mg/kg by i.v infusion at a rate of not faster than 50mg/min, then 300mg/day. Or, Sodium valproate 10mg/kg i.v over 3-5 minutes and then 800-2000mg/day. Or, Carbamazepine 400mg by nasogastric tube then 400-1200mg/day. 5. If seizures yet not controlled with above medication- Chlormethiazole 0.8%, 40-400ml can be given by i.v infusion at 5-15ml/min. to stop fits and then continued at 0.5-lml/min. 6. In refractory cases of seizure, thiopentone can be used to control status epilepticus where facilities for artifical respiration are available; thiopentone 100-250mg as a bolus over 20 sec, then repeat 50mg boluses every 2-3 minutes until seizures are controlled; then continue infusion at 3-5mg/kg/hour if needed. 7. If seizurs still continue- investigate for other causes. 8. Regular checking of vital signs, neurological conditions; recording of blood pressure, pulse, respiration & analysis of blood gases should be done. |
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