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Status epilepticus causes seizures that cause convulsions and disturbances in consciousness. If the seizure lasts too long and is not handled properly and promptly, it will cause a clinical picture of brain damage.
1. What is status epilepticus?
Status epilepticus is an electrophysiological-clinical syndrome. Status epilepticus is characterized by successive, recurrent seizures. There is a short interval between seizures (change in consciousness) due to damage to neurons in the cerebral cortex that cause seizures. If the seizure lasts too long, it will cause a clinical picture, brain damage with many other serious consequences.
When there is a convulsion lasting more than 30-45 minutes, it can cause brain damage (especially limbic structures such as hippocampus): brain, neurological sequelae, permanent intellectual. In addition, status epilepticus can have many other consequences.
2. What causes status epilepticus?
2.1 Due to acute central nervous system injury Patient has encephalitis or meningitis, cerebral venous thrombosis, cerebrovascular diseases, due to impact, trauma, hypertension, anemia , reduce oxygen,...
Tổn thương dây thần kinh trung ương cấp tính có thể gây ra trạng thái động kinh
2.2 Patients with chronic central nervous system damage People with a history of diseases related to cerebrovascular accident or brain tumor. Sudden rise or fall in blood sugar. 2.3 Epilepsy People with psychiatric epilepsy, the patient stops or changes the dose of oral antiepileptic drugs.
3. Consequences and complications of status epilepticus if not promptly handled?
Convulsions lasting from 30 to 45 minutes due to epilepsy without timely intervention will cause severe complications for patients related to the brain, neurological sequelae, permanent intellectual, even death. .
In addition, it also causes other consequences for patients such as:
Traumatic brain injury, shoulder dislocation, broken bones, broken organs Respiratory disorders: stagnation, pneumonia due to aspiration, respiratory acidosis. Hemodynamic disturbances, body temperature, dehydration, rhabdomyolysis
Người bị động kinh nếu không được can thiệp và xử lý kịp thời có thể dẫn đến tử vong
4. Handling status epilepticus? Convulsions treatment protocol
When a patient has a seizure such as a convulsion, the most important thing is to ensure basic life functions such as: respiration, hemodynamics, metabolic acidosis, body temperature, first aid for injuries
Cut off the attacks convulsion as quickly as possible with every available drug.
4.1 Ensure breathing Protect airways by intubation, suction sputum, give ventilatory control mode if patient is in coma
4.2 Ensure hemodynamics Monitor heart rate, blood pressure
4.3 Metabolic acidosis Requires monitoring of arterial blood gases
Cần theo dõi và đảm bảo các chức năng sống cơ bản của người bệnh
4.4 Check the body temperature A convulsion will cause the body temperature to rise, if not intervened in time, it can cause severe damage to the central nervous system.
Therefore, must check the patient's temperature, make sure the body temperature must be lower than 39 degrees Celsius by applying cold compresses, ventilation, ventilation, giving paracetamol to reduce fever about 0.5g every 4 hours.
4.5 Prophylaxis and treatment of rhabdomyolysis, give the patient frequent urination
4.6 The patient has cerebral edema Have the patient lie down on a pillow about 45 degrees high, control convulsions Use Manitol as a rapid intravenous infusion within 30 minutes from 0.5 to 1 g/kg based on weight, every 4-6 hours as an infusion. Use Methylprednisolone 40mg for intravenous injection, every 6-8 hours. Or use Dexamethasone in meningitis. Status epilepticus will be very dangerous if not promptly intervened. Therefore, if seizures occur, it is necessary to quickly bring the patient to the nearest reputable clinic or facility to avoid brain damage and complications.
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