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Status Epilepticus — Emergency Management

A continuous seizure or repetitive seizures lasting longer than 5 minutes constitute a neurological emergency.

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Acil Servis department. Book Appointment →

What is Status Epilepticus — Emergency Management?

Status epilepticus is defined as a single seizure lasting longer than 5 minutes or repeated seizures without recovery of consciousness in between.

Convulsive and non-convulsive forms exist; both reflect uncontrolled electrical activity in the brain. Treatment delay increases the risk of permanent neuronal damage.

The most common causes are non-adherence to antiepileptic therapy, alcohol withdrawal, stroke, central nervous system infection, electrolyte imbalance and intoxication.

Symptoms

Continuous tonic-clonic seizure activity
Loss of consciousness without recovery
Foaming at the mouth, tongue biting
Urinary or stool incontinence
Cyanosis and respiratory difficulty
Signs of head trauma
Subtle eye deviation or facial twitching (non-convulsive form)

Risk Factors

Known epilepsy and missed antiepileptic doses
Alcohol or benzodiazepine withdrawal
Acute stroke or head trauma
Central nervous system infection (meningitis, encephalitis)
Severe hyponatraemia or hypoglycaemia
Drug intoxication (cocaine, tramadol, INH)
Brain tumour

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • Call 112 immediately for any seizure lasting longer than 5 minutes
  • Always seek emergency assessment if a second seizure occurs without recovery in between
  • Urgent admission is required when consciousness does not return after the seizure
  • Bring the medication list of a known epileptic patient to hospital

Treatment Methods

01
Airway, breathing, circulation (ABC) stabilisation
02
Intravenous lorazepam or intramuscular midazolam (first line)
03
Intravenous levetiracetam, valproate or fenitoin (second line)
04
Intubation and continuous EEG monitoring in the intensive care unit
05
Anaesthetic infusion with propofol, midazolam or thiopental for refractory status
06
Identification and treatment of the underlying cause (glucose, thiamine, electrolytes, antibiotics)

Which Department to Visit?

You can visit our Acil Servis department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

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You can make an appointment with our specialists or contact us for your concerns.

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.