Don’t Ignore the Storm: Recognizing and Treating Status Epilepticus (SE)

Introduction

Status epilepticus (SE) is a medical emergency characterized by prolonged or repeated back-to-back seizures lasting longer than five minutes, occurring without full recovery of consciousness between seizures, muscle rigidity, convulsions, and breathing difficulties. It is a life-threatening condition that requires immediate medical attention and can occur in people of all ages but is more common in children and older adults. 

Factors

A variety of factors, including epilepsy, brain injury, stroke, brain tumors, and infections, drug and alcohol withdrawal, certain medications, such as antidepressants and antipsychotics, and metabolic disorders, such as low blood sugar and low blood sodium, can cause SE.

Diagnosis

Diagnosing SE requires a thorough medical evaluation, including a physical exam, medical history, and diagnostic tests such as an electroencephalogram (EEG), which measures the brain’s electrical activity to help diagnose seizures and determine the type of seizure; blood tests for metabolic disorders; and imaging tests, such as CT scans and MRI, which identify brain injuries, tumors, and other abnormalities.

Treatment

The goal of treatment for SE is to stop the seizures as quickly as possible to prevent brain damage and other complications. Treatment may include medications, such as benzodiazepines and antiepileptic drugs, which are often used to stop seizures; oxygen therapy to improve breathing during a seizure; intravenous fluids to prevent dehydration and maintain electrolyte balance; mechanical ventilation if breathing difficulties persist; and in some cases, surgery to remove brain tumors or other abnormalities causing SE.

Prevention

Preventing SE involves managing the underlying condition causing seizures. Some strategies for preventing SE include taking medications as prescribed, avoiding triggers such as alcohol and sleep deprivation, and managing underlying conditions such as brain tumors or metabolic disorders.