Status epilepticus is said to exist when a series of seizures occurs without the patient regaining consciousness between attacks. This condition is life-threatening.

INVESTIGATIONS

As for epilepsy

MANAGEMENT

Non-pharmacological Treatment

• Remove false teeth if present
• Insert a Brook’s airway (oropharyngeal tube) to maintain airway
• Give oxygen

Pharmacological Treatment

• If hypoglycaemia is suspected treat as appropriate for adult or child (see section on hypoglycaemia)

• Give Diazepam, IV or rectal (see appropriate section)

• If seizures continue set up IV infusion of Diazepam in Sodium Chloride 0.9% 40-80 mg per litre to be infused over six hours. Give at 5 mg/min until seizures stop or 20 mg given or significant respiratory depression occurs

• If seizures still uncontrolled 60 minutes after it began, paralyze and ventilate under anaesthesia. Transfer to a facility where this can be done

DON’TS FOR EPILEPTIC PATIENTS

• Driving of a vehicle
• Swimming
• Working at heights
• Excessive alcohol ingestion
• Machine operation