Status epilepticus (peds): Difference between revisions
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**Seizure >5 min and/or ongoing seizure on presentation | **Seizure >5 min and/or ongoing seizure on presentation | ||
**2 or more seizures without full recovery of consciousness between seizures | **2 or more seizures without full recovery of consciousness between seizures | ||
* Categorized as convulsive or non-convulsive | |||
** Convulsive status epilepticus: patient will have tonic-clonic movements with altered mental status, may have focal neuro deficits post-ictally (Todd's paralysis) | |||
** Non-convulsive status epilepticus: patient will have seizure activity on EEG without clinical findings | |||
==Clinical Features== | ==Clinical Features== | ||
Revision as of 23:46, 2 October 2022
Background
For a child over 1 month of age
- Defined as: an unresponsive patient with either one of the following
- Seizure >5 min and/or ongoing seizure on presentation
- 2 or more seizures without full recovery of consciousness between seizures
- Categorized as convulsive or non-convulsive
- Convulsive status epilepticus: patient will have tonic-clonic movements with altered mental status, may have focal neuro deficits post-ictally (Todd's paralysis)
- Non-convulsive status epilepticus: patient will have seizure activity on EEG without clinical findings
Clinical Features
Differential Diagnosis
Evaluation
Workup
- Check a blood glucose
- Consider an electrolyte panel, a blood gas, CBC, calcium level, LFTs
- If appropriate collect anticonvulsant drug levels
- Consider blood & urine culture
Diagnosis
Management
- ABC's
- Provide O2 via non-rebreather mask, 10-15 L/min
- Give benzodiazepines as early as possible
- Monitor for respiratory depression
- Give acetaminophen 15 mg/kg/dose (MAX 650 mg) if febrile