Status Epilepticus

Symptoms, Doctors, Treatments, Advances & More

Status epilepticus (SE) is defined as an extremely rare condition of experiencing prolonged epileptic seizures (convulsions caused by abnormal electrical activity in the brain) lasting longer than five minutes or a single seizure lasting longer than five minutes without a return to consciousness. Status epilepticus is considered to be a medical emergency. Status epilepticus is categorized into three subtypes: 1) Generalized Convulsive Status Epilepticus (GCSE), characterized by convulsions with abnormal, rapid eye movements, drooling, jerking limb movements, and grunting; and 2) Subtle Convulsive Status Epilepticus, characterized by abnormal, rapid eye movements, facial twitching, and subtle jerking of the limbs; and 3) Non-Convulsive status epilepticus (NCSE), also known as Complex Partial Status Epilepticus, characterized by confusion, abnormal, rapid eye movement, an appearance of daydreaming, possible loss of speech, personality changes, and irrational behavior or psychosis).

Symptoms of status epilepticus vary by individual but may include falling, an appearance of daydreaming, confusion, abnormal, rapid eye movements, facial twitching, muscle spasms, jerking limb movements, clenched teeth, drooling, irregular breathing, grunting or making other unusual sounds, inability or difficulty speaking, irrational behavior or psychosis, and loss of bladder or bowel control. Some individuals with epilepsy may experience visual disturbances (aura) before the onset of a seizure, such as seeing flickering lights or sunbursts.

Status epilepticus is considered to be a medical emergency and requires urgent treatment to prevent permanent brain damage or death. The main treatments for status epilepticus are anticonvulsant drugs and drugs to prevent seizures, which include acetazolamide, carbamazepine, clonazepam, corticotrophin, corticosteroids, Diastat (diazepam suppository rectal gel), ethosuximide (Zarontin), felbamate (Felbatol), fosphenytoin sodium (cerebyx), lamotrigine (Lamictal), lorazepam, Neurontin (gabapentin), paraldehyde, phenobarbital, phenytoin, primidone, topiramate (Topamax), trimethadione, valproic acid. Depending on the cause, such as a brain tumor or drug resistant temporal lobe epilepsy, some patients with status epilepticus may need surgery after first trying medications to stop the seizures. During a seizure characterized by status epilepticus (five minutes or longer), emergency assistance should be called immediately, while individuals experiencing an epileptic seizure should be protected from injury by removing any sharp or hard objects close by, loosening tight clothing, and placing a flat, soft object under the head. Do not attempt to restrain the individual. If possible, the individual experiencing a seizure should be turned on their side with something soft and flat placed between the teeth. Cardiopulmonary resuscitation (CPR) may be necessary if the individual stops breathing after a seizure has ended. Oxygen may be administered by health professionals. After the seizure has ended, the individual should be allowed to sleep while awaiting emergency services.