Status epilepticus

What it is

Status epilepticus is a neurological emergency. It is seizures lasting more than 5 minutes, or two back to back seizures without regain of consciousness in between; the same is put as 5 or more minutes of either continuous seizure activity or repetitive seizures without regaining consciousness.

How it presents

Two described cases both meet this. In the first, a witnessed generalized tonic clonic seizure lasts more than 5 minutes, with symmetric tonic clonic movements, uprolling of the eyes, bloody frothing and bladder incontinence. In the second, a seizure lasts less than 1 minute and is followed by another exact event lasting 1.5 minutes, with no regaining of consciousness between the 2 events.

Causes and risk

The causes listed are prolonged febrile seizure, new onset epilepsy, drug intoxication, drug withdrawal, hypoglycemia, electrolyte imbalance, infection, acute head trauma, hypoxia, metabolic disorders, intracranial hemorrhage and ischemic stroke. Where the most common cause is asked among infection such as encephalitis, non-compliance of anti-epileptic drugs, alcohol withdrawal, hypoglycemia and acute traumatic brain injury, the answer marked is non-compliance of anti-epileptic drugs: a tick in red stands beside it, and a red question mark beside the tick.