Status Epilepticus

Question 1

What is status epilepticus

Answer 1

Rapidly repeating seizures without recovery between episodes or prolonged epileptic activity

Question 2

How long does status epilepticus last

Answer 2

30 min or more

5-10 min impending in children

Question 3

What is the incidence rate of status epilepticus

Answer 3

17-108/100,000
1-8% of hospital admission for epilepsy are for SE
4-16% with epilepsy have at least one episode of SE
1/3 first seizure
1/3 no history
1/3 established epilepsy

Question 4

What is the underlying mechanism of status epilepticus

Answer 4

Loss of inhibition

Question 5

What happens in crowding effect

Answer 5

Healthy tissue takes over damaged tissue in an attempt to recover function - forgoes specialization for proper development

Question 6

What brain structure is most vulnerable with status epilepticus

Answer 6

Hippocampus - can cause sclerosis

Question 7

Who is most effected by status epilepticus

Answer 7

Younger children prior to 11 months presenting with febrile status epilepticus

Question 8

What functions are most vulnerable after status epilepticus

Answer 8

Hand-eye coordination, motor ability, and memory - executive function depends on critical period of development

Question 9

What is the prognosis for status epilepticus

Answer 9

Idiopathic status epilepticus tends to have more favorable prognosis than symptomatic status epilepticus

Question 10

Risk of developing seizures after status epilepticus

Answer 10

50% in convulsive symptomatic status epilepticus

20% with acute symptomatic status epilepticus
Developmental and cognitive impairment - compared to 10% in other types of status epilepticus

Question 11

Suggested hypothesis for resilience in status epilpticus

Answer 11

Brain can develop tolerance to recurrent seizure more than naive brain

Question 12

Cognitive findings in status epilepticus

Answer 12

Younger children - more severe etiologías - 75% under 2 with status epilepticus had normal development before SE. Increased risk for neuronal injury or death > or equal to an hour

Question 13

Findings for gender with SE

Answer 13

Males have a higher propensity of developing idiopathic SE but gender itself does not impact prognosis

Question 14

What does it mean for seizures to be refractory

Answer 14

Seizures persist despite adequate treatment

Question 15

Prognosis of status epilepticus depends on

Answer 15

Etiology, age, and duration

Question 16

Causes of status epilepticus

Answer 16

Noncompliance with AED, alcohol withdrawal, trauma, tumor, vascular disease, congenital abnormalities, or anoxia

35% for fever or infection
20% for medication change