- Epilepsy - symptoms and help the patient
- Status epilepticus: symptoms
- Status epilepticus: causes
- Status epilepticus: diagnosis
- Status epilepticus: treatment
- Status epilepticus: prognosis
- Status epilepticus: first aid
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Status epilepticus is a specific form of an epileptic seizure that lasts longer than a typical seizure or consists of the occurrence of seizures, one after another, continuously. Status epilepticus is considered a life-threatening condition and, interestingly, not only people with epilepsy experience it. So what are some of the other causes of status epilepsy, and what can we do when a loved one experiences this problem?
Status epilepticusis a medical emergency. Epilepsy is generally regarded as quite serious. Most people associate seizures with seizures, which often arouse anxiety in people who see them.
In fact, however, a single seizure is not the most serious risk associated with epilepsy. The greatest risk for epilepsy patients is caused by status epilepsy and which can definitely be treated as a life-threatening condition.
Having epilepsy is by far not the only possible cause of status epilepticus.
The definition of status epilepticus has changed over time. Until some time ago, this problem was defined as a situation in which a patient experienced a seizure lasting more than 30 minutes.
Typically, however, epileptic seizures last for a minute to about three, and then subside, which was certainly one of the factors that led to the change in the above-mentioned criterion.
Currently, status epilepticus is diagnosed when an epileptic seizure lasts for 5 minutes or more.
Status epilepticus can also be found in a situation where the patient experiences two or more seizures immediately after each other, between which there is no improvement in the patient's condition or the return to full consciousness.
- Seizures: types
Statistics on the incidence of status epilepticus vary. According to available studies on US patients, status epilepsy affects 6 to 40 people out of 100,000 people.
As the name of the problem suggests, status epilepticus is related to epilepsy, but interestingly, not only patients can experience this dangerous entitysuffering from epilepsy. In fact, there are many different he alth problems that can cause status epilepticus.
Epilepsy - symptoms and help the patient
Status epilepticus: symptoms
Due to the clinical course, there are two main types of epileptic states.
The first of these areconvulsive epileptic states , which are associated with various movement disorders - in this type of epileptic state, patients may experience, for example, tonic symptoms -clone.
- Epilepsy symptoms in children and adults. How to recognize epilepsy?
Another type of problem described isnon-convulsive epileptic states . What is characteristic of them, in turn, is not the movement disorders themselves, but rather the patients' consciousness disorders. The non-convulsive status epilepticus can manifest itself in the form of a prolonged attack of unconsciousness, for example.
The characteristic feature of status epilepticus, distinguishing it from a single seizure, is the aforementioned duration of the symptoms (exceeding 5 minutes) or the occurrence of two or more seizures directly in succession, between which there is no improvement in the patient's condition .
It was previously noted that status epilepticus - especially in the form of a prolonged seizure - is considered a life-threatening condition.
It is related to the fact that this problem may lead to various complications, among which the most serious is the possibility of heart rhythm disturbances and breathing disorders.
Status epilepticus: causes
Status epilepticus is obviously related to epilepsy, but in fact, of all people who experience this problem, epilepsy patients account for about 25%.
For people with this condition, status epilepticus may be the first symptom of the condition - some patients are diagnosed with epilepsy just after they develop status epilepticus.
However, the problem may also occur in those patients with epilepsy who are treated for this disease. This may be the case, for example, when:
- the patient starts taking new antiepileptic drugs
- the concentration of antiepileptic drugs in the body changes for various reasons (this may be the case, for example, in the course of gastrointestinal infections, where due to vomiting or diarrhea there is a reduced absorption of drugs from the gastrointestinal tract; another possibility is the one in which the patient starts taking other medicationswhich interact with antiepileptic agents, thereby reducing the levels of anticonvulsants in the body)
- you will suddenly stop taking your AEDs
- the patient will be deprived of an adequate amount of sleep
- a patient treated with some antiepileptic substances will develop resistance to the drug
- A patient using antiepileptic drugs will abuse alcohol
Having epilepsy is definitely not the only possible cause of status epilepticus.
Disorders of the brain's electrical activity, which are the essence of the epileptic state, can also be caused by such pathologies as:
- stroke
- intracranial bleeding
- tumors of the central nervous system
- infectious diseases of the central nervous system (e.g. meningitis or brain abscess)
- head injuries
- withdrawal syndrome occurring after withdrawal of alcohol, especially from chronic abuse
- metabolic disorders (e.g. related to hyponatraemia or hepatic encephalopathy)
Status epilepticus: diagnosis
The diagnosis of status epilepticus is based primarily on the identification of features characteristic of this pathology.
If a patient has been diagnosed with epilepsy before the onset of status epilepsy, it is very important for doctors to obtain this information, as it narrows down the differential diagnosis that must be performed due to how many causes of status epilepsy may be.
In patients with status epilepsy, many different tests can be performed, including:
- laboratory (to measure blood glucose or determine inflammatory markers)
- imaging (such as e.g. computed tomography or magnetic resonance imaging of the head).
This necessity arises from the fact that it is important to find the cause of status epilepticus, as well as to differentiate this individual from other conditions that may manifest themselves in a similar way. Examples of such units include:
- Neuroleptic Malignant Syndrome
- psychogenic pseudo-epileptic seizures
- malignant hyperthermia
- heat stroke
- hypoglycemia
Status epilepticus: treatment
Time plays the most important role in the treatment of status epilepticus - because the sooner the treatment of this individual is started, the greater the chances that it will be resolved sooner.
Proceedings instatus epilepticus is based on drug treatment.
- Pharmacological and surgical treatment of epilepsy
Basically, the first drugs that are given to patients are benzodiazepines, such as alprazolam, diazepam or midazolam.
Subsequently - if symptoms persist despite the above-mentioned drugs being administered to the patient - it may become necessary to use other drugs, such as phenytoin, valproic acid or levetiracetam.
If the epileptic status persists, sometimes doctors decide to introduce a pharmacological coma - barbiturate (using e.g. thiopental).
Status epilepticus: prognosis
It is difficult to clearly define the prognosis of patients with status epilepticus as it differs depending on the cause of the problem - patients with status epilepticus associated with meningitis are different, and the prognosis for patients with status epilepticus is different. patients suffering from a brain tumor and prolonged seizures associated with it.
The most important thing for the resolution of status epilepticus is the quick initiation of its treatment - the early initiation of therapy increases the chances of a patient's recovery quickly, and also reduces the risk of complications of status epilepticus.
Status epilepticus: first aid
Whenever we see a person experiencing a seizure event - be it a single seizure or status epilepticus - first of all, stay calm.
First of all, it is important to make sure that the person suffering from convulsions is not at risk of harming their body - it is worth looking around, for example, whether they are lying on an extremely hard surface. It is best to put the sick person on their side, which reduces the risk of choking. In addition, you should try to keep his airways open.
It is possible that we observe a seizure from the very beginning.
- Seizure - first aid
In such a situation, we can take care of the patient's safety and observe him at the same time - if the epileptic seizure does not resolve spontaneously within two or three minutes, it is best to call an ambulance.
In a situation where we encounter a person with a seizure and we do not know how long it lasts - then it is best to call for help immediately.
After allmedical. Sources:1. Epilepsy Foundation Materials; on-line access: http://www.epilepsy.com/learn/challenges-epilepsy/seizure-emergencies/status-epilepticus2. Julie L. Roth, Status Epilepticus, Medscape; on-line access: http://emedicine.medscape.com/article/1164462-overview3. Ajith Cherian, Sanjeev V. Thomas, Status epilepticus, Ann Indian Acad Neurol. 2009 Jul-Sep; 12 (3): 140-153; on-line access: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2824929/
Epilepsy - more information:
- Epilepsy syndromes: types
- Childhood epilepsy with absences (pycnolepsy, Friedman syndrome)
- Roland's Epilepsy
- West's Epilepsy Syndrome
- Northern epilepsy
- Alcoholic epilepsy