acute seizure management

Question 1

when should drug treatment for a seizure occur

Answer 1

After 5 min of continuous seizure activity

Question 2

Causes of acute symptomatic seizures

Answer 2

Metabolic- hypoglycemia, hyponatremia, hypocalcemia, kidney failure
Intoxication or w/d
Stroke
Brain trauma
Intracranial infection - encephalitis, meningitis, brain abscess
Autoimmune encephalitis
HTN encephalopathy
Severe cerebral hypoxia
Eclampsia

Question 3

Acute management of seizure

Answer 3

Position on L side, protect airway and maintian oxygenation
- connect monitoring equipment, obtain BGL, obtain IV access
Bloods for- FBC, UEC, VBG

Question 4

Acute managemnt of status epilepticus

Answer 4

1. give benzo
   IV access available- midazolam or diazepam 10mg IV over at least 2 min OR clonazepam 1mg

IV access not available - midazolam 10mg IM/buccal/intranasal

2. give antiepileptic
   levetiracetam, sodium valproate, phenytoin
3. Transfer to ICU and seek expert advice

Question 5

cx of seizures

Answer 5

Aspiration
Trauma - posterior shoulder dislocaiton
CNS injury
non cardiogenic pulmonary edema
rhabdomyolysis, acidosis, kidney failure
hyperthermia