Status epilepticus is a continuous seizure state. It occurs when a person has a continuous epileptic seizure or one seizure followed by another without the person regaining consciousness. It can occur in all types of seizures.
Seizures are due to a temporary electrical disturbance in the brain. This can affect all areas of the brain or it can spread out from a single area. Status epilepticus occurs when the seizure continues for a long period of time. During this time, the person never regains consciousness. This type of prolonged seizure can result in death if it is not treated right away.
Any condition that might causes structural damage to the brain can lead to status epilepticus. These include:
Status epilepticus can occur at any age. However, it usually affects the very young and very old. It is a medical emergency which can be fatal unless it is treated right away.
Status epilepticus can be convulsive or nonconvulsive. A person's symptoms can range from simply appearing dazed to the more serious muscle contractions, spasms, and loss of consciousness. The specific symptoms depend on the underlying type of seizure. The person may also have high blood pressure, rapid heartbeat, irregular heartbeats known as arrhythmias, and high blood sugar levels.
The healthcare provider can diagnose some attacks of status epilepticus by observing the person. This is especially true for generalized convulsive status epilepticus. Other cases are more difficult to diagnose, such as nonconvulsive status epilepticus. A variety of laboratory and other special tests aid in the diagnosis.
Emergency treatment will continue while these tests are being done:
A person who is taking medications to prevent seizures should take them as prescribed. If the level of medication in the bloodstream falls too low, status epilepticus may occur.
Status epilepticus can lead to permanent damage to the brain and heart, and to death.
There are no risks to others.
Time is the critical issue. A person will be given emergency care while the cause of the seizure is being determined. Emergency care includes:
Side effects of treatment depend on the medications given. Antiseizure medication may cause drowsiness in some people and hyperactivity in others.
After emergency treatment, a person will need to take any daily seizure medications exactly as prescribed.
A person will need follow-up visits to the healthcare provider to make sure that the level of medication in the bloodstream is appropriate. The dose may need to be adjusted. The person should wear a MedicAlert bracelet that indicates he or she has epilepsy.
Author:Eric Berlin, MD
Date Written:
Editor:Smith, Mary Ellen, BS
Edit Date:08/14/00
Reviewer:Gail Hendrickson, RN, BS
Date Reviewed:07/01/01
www.aafp.org
The Merck Manual, 1999
Harrison's Principles of Internal Medicine, 1991