By: Catherine Joachin
What is status epilepticus?
Status epilepticus (SE) is a life-threatening emergency characterized by a long seizure or several consecutive seizures lasting at least five minutes without transitional episodes of regular consciousness in-between (Cleveland Clinic, n.d.). This condition requires immediate medical attention as it can lead to lifelong brain injury or death (Johns Hopkins Medicine, 2019.).
Who does SE target?
Status epilepticus is more likely to affect people with a history of epilepsy; however, other risks factors are associated with the condition (Cleveland Clinic, n.d.).
These include:
• Alcohol or drug abuse/withdrawal
• Autoimmune disorders
• Head trauma
• Hypertensive emergency
• Low blood sugar and other metabolic issues
• Stroke
• Cerebral hypoxia
• Kidney failure
• Liver failure
• Central nervous system infections (e.g., encephalitis)
• HIV
• Genetic diseases (e.g., Fragile X syndrome, Angelman syndrome)
(Johns Hopkins Medicine, 2019; Wylie, Sandhu & Murr, 2023)
Infants and elderly adults are also at higher risk for experiencing status epilepticus (Cleveland Clinic, n.d.). In fact, it is the most prevalent pediatric neurological emergency (Wylie, Sandhu & Murr, 2023).
Causes and Symptoms
Status epilepticus can be provoked by a variety of afflictions including fevers, strokes, low blood sugar, and alcohol withdrawal (Johns Hopkins Medicine, 2019.).
The condition can present itself as convulsive or nonconvulsive.
• Convulsive status epilepticus involves involuntary shaking, grunting, drooling, and rapid eye movements. These motions may result in permanent injury,
• Nonconvulsive status epilepticus involves a noticeable impairment in mental state, presenting as confusion and irrational behavior. Minor muscle twitches or unusual eye movements may still occur.
(Johns Hopkins Medicine, 2019; Wylie, Sandhu & Murr, 2023).
Conditions with similar symptom presentation include:
• Acute intoxication
• Early catastrophic brain hypoxia
• Encephalopathy of toxic and metabolic origin
• Ischemic stroke
• Non-epileptic seizures
• Brain trauma
(Wylie, Sandhu & Murr, 2023)
Diagnosis and Treatment
Status epilepticus can be diagnosed and monitored with the help of an electroencephalogram (EEG), however, investigation into the etiology of a patient’s seizures may warrant the use of different exams such as blood tests, lumbar punctures, CT scans, or MRIs (Cleveland Clinic, n.d.).
Treatment for status epilepticus mainly focuses on stopping seizure activity and attending to any underlying causes of the condition. These goals can be achieved with the help of various methods including medication, intubation, and surgery, to name a few (Cleveland Clinic, n.d.).
Anti-seizure drugs, which can be administered through an intravenous line (IV) or directly injected into a muscle, are commonly regarded as first-line treatment for SE, with more severe cases requiring patients to enter medically induced comas to protect them from further injury (Cleveland Clinic, n.d.).
Conclusion
In conclusion, status epilepticus is a dangerous condition marked by lengthy or rapid succession seizures. While more common in people with epilepsy, any disorder that can give rise to seizures is a risk factor for status epilepticus. Despite the condition’s potentially debilitating nature, recovery and remission are possible with rapid intervention.
References
Cleveland Clinic (n.d.). Status Epilepticus. Cleveland Clinic. Retrieved from https:// my.clevelandclinic.org/health/diseases/24729-status-epilepticus#management-and-treatment
Johns Hopkins Medicine (2019). Status Epilepticus. Johns Hopkins Medicine. Retrieved from: https://www.hopkinsmedicine.org/health/conditions-and-diseases/statusepilepticus
Wylie, T., Sandhu, D. S., & Murr, N. (2023). Status Epilepticus. StatPearls [Internet] – NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK430686/
