Status epilepticus

Status epilepticus is sustained epileptic activity with
1. two fits without recovery of consciousness in between
OR
2.single fit of >30 mins with or without loss of consciousness


Treatment aims at controlling seizures within 1 hour of admission.

STEP A (first 20 mins)

  • Maintain ABC (airway, breathing, circulation)
  • measure blood sugar
  • take a brief history
  • Administer Diazepam (10 mg iv over 1-2 mins)
  • Administer Phenytoin (20 mg/kg)

IF SEIZURES ARE NOT CONTROLLED, GO TO STEP B

STEP B (20-60 mins)

  • Give Phenobarbital or Diazepam infusion.

IF SEIZURES ARE NOT CONTROLLED, GO TO STEP C

STEP C

  • Administer General anesthesia or Thiopental infusion

Simultaneously, monitor BP, electrolytes and provide ventilation.

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