Your SlideShare is downloading. ×
0
Status epilepticus
Status epilepticus
Status epilepticus
Status epilepticus
Status epilepticus
Status epilepticus
Status epilepticus
Status epilepticus
Status epilepticus
Status epilepticus
Upcoming SlideShare
Loading in...5
×

Thanks for flagging this SlideShare!

Oops! An error has occurred.

×
Saving this for later? Get the SlideShare app to save on your phone or tablet. Read anywhere, anytime – even offline.
Text the download link to your phone
Standard text messaging rates apply

Status epilepticus

275

Published on

Published in: Health & Medicine, Business
0 Comments
0 Likes
Statistics
Notes
  • Be the first to comment

  • Be the first to like this

No Downloads
Views
Total Views
275
On Slideshare
0
From Embeds
0
Number of Embeds
0
Actions
Shares
0
Downloads
21
Comments
0
Likes
0
Embeds 0
No embeds

Report content
Flagged as inappropriate Flag as inappropriate
Flag as inappropriate

Select your reason for flagging this presentation as inappropriate.

Cancel
No notes for slide

Transcript

  • 1. STATUS EPILEPTICUS (SE) Status epilepticus is defined as continuous convulsion lasting for more than 30 minute or serial convulsion between which there is no regain of conciousness.
  • 2. TYPES : 1. Convulsive. 2. Non convulsive. • Convulsive SE is more important because it is associated with increased risk of morbidity & mortality. • MORTALITY RATE : 3—10%. • Majority of death occurs due to underlying brain disease.
  • 3. ETIOLOGY : • 25 % Prolonged febrile convulsion. • 25% Idiopathic SE with no CNS abnormality. • 25% Symptomatic SE with CNS abnormality or metabolic disorder. • 25% : Meningitis, Encephalitis. - Head trauma , Drug intoxication. - Sub arachnoid hemorrhage. - Pyridoxine dependency.
  • 4. PREDISPOSING FACTOR : • Sleep deprivation. • Intercurrent infection. • Watching TV, Vedio game , Music for prolonged period. • Alcohol, AED Withdrawl.
  • 5. MANAGEMENT : • GOALS OF MANAGEMENT : 1. Stabilization of patient. 2. To stop clinical and electrical seizure activity. 3. Prevent recurrence of seizure. 4. Identification and T/t of etiology.
  • 6. Admit the baby in ICU. STABILIZATION OF PATIENT : Maintenance of ABC . • A – Clear AIRWAY –suction & position. • B – support BREATHING .—O2 inh., Bag & mask ventilation. • C –Circulation.—maintenance of BP. • Moniter –temp, HR, RR, BP & Pulse oxymetry. • All the drugs should be given Intravenously.
  • 7. STEPS OF DRUG ADMINISTRATION 1. Diazepam 0.2—0.3mg/kg or Lorazepam 0.1 mg/kg— Wait10min . If seizure stops, — No T/t. 2. If seizure continues at 10 min—repeat Diazepam/ Lorazepam 3. If still convulsion after 10 min. , start phenytoin 20mg/kg. (@ 1mg/kg/min.) or phenobarbitone –20mg/kg over 20 min. 4. If convulsion continues— Midazolam 2mg/kg stat then 1—10 microgram/kg/ min IV drip. 5. No control – Thiopental / IV paraldehyde/ General Anasthesia .
  • 8. If hypoglycemia detected – give 4ml/kg of D25. If delay in IV access : • 0.5 mg/kg of Diazepam or 0.3ml/kg paraldehyde ( 1:1 diluted with oil in glass syringe ) can be given Rectally. • During administration of AED— HR, RR ,BP, cardiac monitor . • Multiple medication with repeated doses may cause Respiratory distress and may require Ventilator .
  • 9. INVESTIGATION : • CBC , ABG , Serum electrolytes , AED level , Blood sugar. • Urine , Blood & Gastric aspirate for toxicological screening. • Lumbar puncture is deffered till the vitals stable. • CT scanning may be done later .
  • 10. INVESTIGATION : • CBC , ABG , Serum electrolytes , AED level , Blood sugar. • Urine , Blood & Gastric aspirate for toxicological screening. • Lumbar puncture is deffered till the vitals stable. • CT scanning may be done later .

×