What is status epilepticus?
A seizure involves abnormal
electrical activity in the brain. It affects both the mind and the body. Many problems
can cause you to have a seizure. These include:
- High fever
- Brain infections
- Abnormal sodium or blood sugar levels
- Head injuries
If you have epilepsy, you may have seizures again and again.
You may have status epilepticus if you have a seizure that lasts longer than 5 minutes,
or if you have more than 1 seizure within a 5-minute period, without returning to a
normal level of consciousness between episodes. This is a medical emergency. It may lead
to permanent brain damage or death.
Status epilepticus is very rare.
Most people with epilepsy will never have it. This condition is more common in young
children and elderly adults.
This condition can occur as:
- Convulsive status epilepticus. This
type occurs with convulsions. It may be more likely to lead to long-term injury.
Convulsions may involve jerking motions, grunting sounds, drooling, and rapid eye
- Nonconvulsive status epilepticus.
People with this type may appear confused or look like they're daydreaming. They
may be unable to speak. They may also behave in an irrational way.
What causes status epilepticus?
In children, the main cause of
status epilepticus is an infection with a fever. In adults, the common causes are:
- Imbalance of substances in the blood, such as low blood sugar
- Drinking too much alcohol or having
alcohol withdrawal after previous heavy alcohol use
- Withdrawal from medicines to treat seizures
Who is at risk for status epilepticus?
There are many risk factors for
status epilepticus, such as:
- Poorly controlled epilepsy
- Low blood sugar
- Kidney failure
- Liver failure
- Encephalitis (swelling or inflammation of the brain)
- Alcohol or drug abuse
- Genetic diseases such as Fragile X syndrome and Angelman syndrome
- Head injuries
What are the symptoms of status epilepticus?
These are possible symptoms of status epilepticus:
- Muscle spasms
- Unusual noises
- Loss of bowel or bladder control
- Clenched teeth
- Irregular breathing
- Strange behavior
- Trouble speaking
- A "daydreaming" look
How is status epilepticus diagnosed?
Your healthcare provider will do a
physical exam. He or she will ask about your past health, any medicines you are taking,
and if you’ve been using alcohol or other drugs.
Your healthcare provider may also order an electroencephalogram. This involves placing painless electrodes onto your scalp to measure the brain's electrical activity.
You may need other tests to search
for possible causes, such as:
- Lumbar puncture (spinal tap) to look for signs of
- CT or MRI scan to see problems in the brain
How is status epilepticus treated?
The healthcare provider will want
to end the seizure as quickly as possible and treat any underlying problems that are
causing it. You may need:
- Blood tests
- An IV (intravenous) line
- Glucose (sugar) if low blood sugar may be causing the
Healthcare providers may also use
anti-seizure medicines to treat the problem, such as:
These medicines are given through
an IV or an injection into a muscle.
What are possible complications of status epilepticus?
Complications depend on the
underlying cause. They can range from no problems to death. If the cause, such as poor
epilepsy control, can be fixed, there may be no problems. If the cause is a stroke or
brain injury, a person may suffer physical disability to even death.
Can status epilepticus be prevented?
If you have epilepsy, taking your
medicines as directed may help you avoid this problem. If you’ve had status epilepticus,
you may need to begin taking seizure medicines or change medicines you’re already
taking. You may also be able to prevent this health problem by:
- Not abusing alcohol
- Controlling your blood sugar
Key points about status epilepticus
- Status epilepticus has many causes.
Some can be prevented, such as low blood sugar or alcohol and drug abuse.
- People who have epilepsy must take
their medicine as told.
- A seizure that lasts more than 5
minutes, or having more than 1 within a 5-minute period is an emergency. Seek care
Tips to help you get the most from a visit to your healthcare provider:
- Know the reason for your visit and what you want to happen.
- Before your visit, write down questions you want answered.
- Bring someone with you to help you ask questions and remember what your provider tells you.
- At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you.
- Know why a new medicine or treatment is prescribed, and how it will help you. Also know what the side effects are.
- Ask if your condition can be treated in other ways.
- Know why a test or procedure is recommended and what the results could mean.
- Know what to expect if you do not take the medicine or have the test or procedure.
- If you have a follow-up appointment, write down the date, time, and purpose for that visit.
- Know how you can contact your provider if you have questions.
Online Medical Reviewer:
Joseph Campellone MD
Online Medical Reviewer:
Raymond Kent Turley BSN MSN RN
Date Last Reviewed:
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