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Status Epilepticus
- Medical emergency: seizures lasting for >30mins, or repeated seizures
without intervening consciousness
- Aim is rapid suppression of seizure activity
Precipitants
Preceding seizure disorder
- non-compliance with medication
- alcohol
No Previous Seizures
- trauma
- infection
- meningitis
- encephalitis
- abscess
- tumour
- stroke
- metabolic
- hypoxia
- drug overdose
- alcohol
Treatment
- Secure airway and give oxygen
- Diazepam 10mg I.V infused over 2mins: n.b. may cause respiratory
depression (or PR)
- Lorazepam 4mg bolus repeated after 10 mins if necessary
- Identification of precipitating factors
- hypoglycaemia
- 50mL of 50% glucose unless glucose is over 5mmol/L
- alcohol
- thiamine if suspect alcohol abuse
- Continue Diazepam until 20mg given, or significant respiratory depression
occurs
- If seizures persist
- start phenytoin 15mg/kg I.V at rate of up to 50mg/min: note, do not
use same I.V. line as diazepam
- IM paraldehyde
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