The diagnosis of generalised tonic–clonic seizures, in which there is loss of consciousness, falling to the ground and clonic movements, is easy but lack of eyewitness accounts can leave uncertainty.
Less dramatic seizures, such as absences or some focal seizures which cause alteration of consciousness without the patient falling to the ground, may merely be experienced as ‘lost time’. Since epileptic seizures are the result of specific processes that vary from patient to patient, their manifestation tends to be intermittent and stereotyped and often clusters in time, for reasons incompletely understood.
Management of status epilepticus
- Ensure airway is patent; give oxygen to prevent cerebral hypoxia
- Check pulse, blood pressure, respiratory rate
- Secure intravenous access
MEASUREMENT
- Glucose, urea and electrolytes, calcium and magnesium, liver function, anti-epileptic drug levels.
- Storing a sample for future analysis.
- Correct any metabolic trigger, e.g. hypoglycaemia
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