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Chapter-47 Status Epilepticus

BOOK TITLE: Critical Care

Author
1. Singhi Sunit C
2. AR Mullai Baalaaji
ISBN
9789351522133
DOI
10.5005/jp/books/12670_48
Edition
1/e
Publishing Year
2016
Pages
8
Author Affiliations
1. Pediatric Emergency and Intensive Care Units, PGIMER, Chandigarh, Advanced Pediatric Centre, Pgimer, Chandigarh, Email: sunit.singhi@gmail.com; dr_singhi@yahoo.com, Maharishi Markandeshwar Institute of Medical Sciences and Research, Ambala, Haryana, India
2. Advanced Pediatric Centre, PGIMER, Chandigarh, Punjab, India, Kovai Medical Center and Hospital, Coimbatore, Tamil Nadu, India
Chapter keywords
Status epilepticus, convulsive SE, nonconvulsive SE, intravenous benzodiazepines, intravenous levetiracetam, thiopental, ketamine, lidocaine

Abstract

Status epilepticus (SE) is a life threatening medical emergency with an estimated incidence of 10–27 per 100,000 per year for children from 1 month to 15 years. It necessitates early recognition and urgent treatment as the outcome depends on the rapidity and adequacy of care. SE is defined as a seizure that persists for a sufficient length of time or is repeated frequently enough to produce a fixed and enduring epileptic condition. Convulsive SE (CSE) and nonconvulsive SE (NCSE) are classification of SE. Infections, metabolic causes, hypoxia, toxins, trauma and idiopathic SE are the important causes of SE. Diagnosis depends on the identification of continuous or repetitive seizures, which is straight forward in convulsive SE. Vagal syncope, cyanotic breath holding spells, jitteriness and psychogenic are key features help in differentiating common paroxysmal nonepileptic event from true seizure episodes. The principal goal of therapy in SE is to abort the seizures before irreversible neuronal injury occurs. Initial stabilization of se and termination of seizures are also discussed in this chapter.

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