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Status epilepticus

From Simple English Wikipedia, the free encyclopedia

Status epilepticus (often simply called status) is a medical emergency where the brain will not stop having seizures. In medicine, a person who is having status epilepticus is described as being "in status."

What is Status Epilepticus?

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Definitions of status epilepticus have changed over time. It used to be that a seizure had to last 20 or 30 minutes to be thought of as status epilepticus.[1] (Most normal seizures last only one to two minutes.)

Today, a person is usually described as being "in status" when:

  • They have a seizure that lasts more than five minutes;[2] OR
  • They have more than one seizure without recovering in between[3]
    • "Recovering" means that the person wakes up and knows who they are; where they are; and what day, month, or year it is[3]

Why is Status Epilepticus a Medical Emergency?

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Status epilepticus is very dangerous. About 10 - 20 % of the people who go into this status die from it.[4]

Status Epilepticus is considered a medical emergency for many reasons:[1][5]

  • During a long seizure, it is very hard for the body to get oxygen to the brain and the heart
    • Without enough oxygen, the brain cannot survive. Not having enough oxygen can cause brain damage and death
    • When the heart does not get enough oxygen, it can start to beat in ways that are not normal (cardiac arrhythmia). If the heart goes without enough oxygen for long enough, it can stop beating
  • Status can cause very high body temperatures (hyperthermia), which can damage the brain
  • Status can cause pulmonary edema - fluid in the lungs - which makes it hard or impossible to breathe. This makes it even harder for oxygen to get to the brain, heart, and the rest of the body
  • The nerves in the brain can get damaged by the extra electricity in the brain that happens during long seizures

If people in status get the right treatment quickly, they can survive with little or no brain damage[6]

Only about one in four people who go into status epilepticus have epilepsy.[6] The other three out of four people who go into status have never had a seizure before.[7] Status epilepticus can happen for many other reasons.

Illnesses

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Many different illnesses can cause status epilepticus:[5][7]

Injuries

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Very bad injuries can also cause status:[5]

Drugs and medications

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Illegal drugs, alcohol, and some medications can cause status:[5][7]

Other causes

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Treatment

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People in status epilepticus are unable to end their seizures on their own. They are often unconscious and unable to react.

The most common way to end status is to inject special medicines that can stop seizures called anticonvulsants. If these medicines do not help, the patient must be treated in the intensive care unit at a hospital. Sometimes patients have to be put into a coma to stop very bad status epilepticus.[1]

References

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  1. 1.0 1.1 1.2 Schachter, Steven C.; Shafer, Patricia O.; Sirven, Joseph I. (August 2013). "Status epilepticus". www.epilepsy.com. Retrieved December 26, 2015.
  2. Misra, UK; Nair, PP; Kalita, J. (Jul–Sep 2011). "Status epilepticus: why, what, and how". Journal of Postgraduate Medicine. 57 (3): 242–52. doi:10.4103/0022-3859.81807. PMID 21941070.
  3. 3.0 3.1 "Epilepsy: Symptoms and Causes". www.mayoclinic.org. The Mayo Clinic. November 6, 2015. Retrieved December 26, 2015.
  4. Trinka, E; Höfler, J; Zerbs, A (September 2012). "Causes of status epilepticus". Epilepsia. 53 (Suppl 4): 127–38. doi:10.1111/j.1528-1167.2012.03622.x. PMID 22946730. S2CID 5294771.
  5. 5.0 5.1 5.2 5.3 Fountain, N.B. (2000). "Status epilepticus: Risk factors and complications". Epilepsia. 41 (Suppl 2): S23-30. doi:10.1111/j.1528-1157.2000.tb01521.x. PMID 10885737. S2CID 34455183. Retrieved December 26, 2015.
  6. 6.0 6.1 Stasiukyniene, V.; Pilvinis, V.; Reingardiene, D.; Janauskaite, L. (2009). "[Epileptic seizures in critically ill patients]". Medicina (Kaunas). 45 (6): 501–7. doi:10.3390/medicina45060066. PMID 19605972.
  7. 7.0 7.1 7.2 "Status Epilepticus: Causes". www.floridahospital.com. Florida Hospital. Retrieved December 26, 2015.