Ver el código de «Status epilepticus»

{{Adult top}} [[Status epilepticus (peds)]].''
==Background==
*Definitions have varied, but status epilepticus should be considered in a patient seizing for 5-10min despite initial treatments or recurrent seizure activity without return to baseline mental status.<ref>Epilepsy Foundation of America. Treatment of convulsive status epilepticus. Recommendations of the Epilepsy Foundation of America's Working Group on Status Epilepticus. JAMA. 1993 Aug 18. 270(7):854-9</ref><ref>Lowenstein DH, Cloyd J. Out-of-hospital treatment of status epilepticus and prolonged seizures. Epilepsia. 2007. 48 Suppl 8:96-8</ref> (Previous definitions used a 30-minute time limit)<ref>Guidelines for epidemiologic studies on epilepsy. Commission on Epidemiology and Prognosis, International League Against Epilepsy. Epilepsia. 1993;34(4):592.</ref>
*Overall mortality is high (22%)<ref name="Martindale">Martindale JL, Goldstein JN, Pallin DJ. Emergency department seizure epidemiology. Emerg Med Clin North Am. 2011 Feb;29(1):15-27.</ref>
*Divided in generalized convulsive status epilepticus (GCSE) and nonconvulsive status epilepticus (NCSE)
**NCSE presents as an alteration in behavior associated with subtle changes (as twitching, blinking, eye deviation, aphasia, somatosensory findings) and continuous epileptiform discharges on EEG

==Clinical Features==
*[[Seizure]] > 20 minutes. <ref>Brodie MJ. Status epilepticus in adults. Lancet. 1990 Sep 1; 336(8714):551-2.</ref>
*Presume status in current seizure > 5 minutes<ref>Lowenstein DH, Alldredge BK.  Status epilepticus.  N Engl J Med. 1998; 338:970-976</ref>

==Differential Diagnosis==
{{Seizure DDX}}

==Evaluation==
*Clinical diagnosis
*Consider emergent CT head, plus/minus LP
*Consider the following labs:
**VBG
**Repeat glucose checks
**Electrolytes including Na, Ca, Mg
**Tox screen
**Serum beta HCG
**CK
**Lactate
**Anti-seizure medication levels

==Managment==
{{Seizure actively seizing management}}

==Disposition==
*Admit to ICU or intermediate level of monitored care depending on etiology, treatments and respiratory status

==External Links==
*IBCC [https://emcrit.org/ibcc/status-epilepticus/ Status Epilepticus] with [https://emcrit.org/ibcc/status-epilepticus/#summary algorithm]
*EM Nerd [https://emcrit.org/emnerd/adventure-dancing-men/ Adventure of dancing men]
*[https://emcrit.org/pulmcrit/esett/ PulmCrit: ESETT Trial]

==See Also==
*[[Seizure]]
*[[Prehospital protocol pediatric seizure]]
*[[Status Epilepticus (peds)]]

==References==
<references/>

[[Category:Neurology]]