Status epilepticus (SE) refers to a life-threatening condition in which the brain is in a state of persistent seizure.

1. Name: Dave Jay Sibi. Manriquez RN. January 15, 2009
Prof: Mrs. Norma Hinoguin Adult Health Nursing Phase II (5:30pm-8:30pm)
STATUS EPILEPTICUS
Status epilepticus (SE) refers to a life-
threatening condition in which the brain is in a state
of persistent seizure. Definitions vary, but
traditionally it is defined as one continuous
unremitting seizure lasting longer than 30 minutes , or
recurrent seizures without regainin consciousness
between seizures for greater than 30 minutes.A seizure
is a sudden disruption of the brain's normal electrical
activity, which can cause a loss of consciousness and
make the body twitch and jerk. This condition is a
medical emergency.
CAUSES:
not taking anticonvulsant medication . It can also be
caused by an underlying condition, such as meningitis,
sepsis, encephalitis, brain tumor, head trauma,
extremely high fever, low glucose levels, or exposure
to toxins.
Status epilepticus can occur in anyone with
epilepsy. It occurs more often in children who have an
underlying neurologic disorder or disease.
This condition is most common in known epileptics.
Within known epileptics, it can be caused by:
• Insufficient dosage of a medication already
prescribed to the patient. Such causes of this
include:
• Forgetfulness on the part of the
patient in taking scheduled doses, or
failure to take doses at the scheduled
times
• Dislike of the medication or its side effects
• Patient's rationing of the medication. This is
usually due to patient's difficulty in affording
medication, or temporary or permanent lack of
access.
• Sudden withdrawal from a seizure
medication. Such causes include:
• Sudden lack of access to medication
due to unexpected circumstances
• Consumption of alcoholic beverages while
on an anticonvulsant, or alcohol
withdrawal. For this among other reasons,
most patients who have active seizure
disorders or who are on anticonvulsants are
advised to altogether avoid consuming alcohol.
• Dieting or fasting while on an
anticonvulsant. Those with epilepsy or who are
on anticonvulsants are advised to consult with
their physicians prior to dieting or fasting.
• Developing a resistance to an anticonvulsant
already being used
• Injury to the patient. This may be the result of
a sports injury, motor vehicle accident,
fall, physical abuse, or other injury that
affects the brain. Though such injuries may
trigger a seizure in anyone, those with a known
seizure disorder are more susceptible.
SYMPTOMS
The characteristic symptom of status epilepticus is
seizures occurring so frequently that they appear to be
one continuous seizure. These seizures include severe
muscle contractions and difficulty breathing.
Permanent damage can occur to the brain and heart if
treatment is not immediate. Status epilepticus can be
convulsive or nonconvulsive. A person's symptoms can
range from simply appearing dazed to the more serious
muscle contractions, spasms, and loss of
consciousness. The specific symptoms depend on the
underlying type of seizure. The person may also have
high blood pressure, rapid heartbeat, irregular
heartbeats known as arrhythmias, and high blood
sugar levels.
Two categories of status epilepticus
Convulsive
Epilepsia partialis continua is a variant
involving hour, day, or even week-long
jerking. It is a consequence of vascular
disease, tumours, or encephalitis, and is
drug-resistant.
Nonconvulsive
Complex partial status epilepticus, or
CPSE, and absence status epilepticus are
rare forms of the condition which are marked
by nonconvulsive seizures. In the case of CPSE,
the seizure is confined to a small area of the
brain, normally the temporal lobe. But the

2. latter, absence status epilepticus, is marked by
a generalised seizure affecting the whole
brain, and an EEG is needed to differentiate
between the two conditions. This results in
episodes characterized by a long-lasting stupor,
staring and unresponsiveness.
NURSING DIAGNOSIS
High Risk for Injury related to seizure acivity
Individual Coping related to perceive social stigma,
potential changes in employment.
PLANNING AND GOALS
The major goals for the patient may include prevetion
of injury, control of seizures, achievement of a
satisfactory psychosocial adjustment, acquisition of
knowledge and understanding about the condition.
How is it diagnosed?
Status epilepticus is diagnosed according to its
characteristic symptoms. The doctor will order tests to
look for the cause of the seizures. These may include
blood tests,
ECG to check for an abnormal heart rhythm;
electroencephalogram (EEG) to check electrical
activity in the brain, a(MRI) or computed tomography
(CT) scans to check for brain tumors or signs of
damage to the brain tissue.
Medication
diazepam (Valium)-to stop motor movement
Phenytoin (Dilantin)
Phenobarbital (Barbita)
Paraldehyde
Thiopental sodium (Pentothal sodium)
General anesthesia may used as a treatment of last
resort to top seizure activity
NURSING PRIORITIES
1. Prevent/control seizure activity.
2. Protect patient from injury.
3. Maintain airway/respiratory function.
4. Promote positive self-esteem.
5. Provide information about disease process,
prognosis, and treatment needs.
DISCHARGE GOALS
1. Seizures activity controlled.
2. Complications/injury prevented.
3. Capable/competent self-image displayed.
4. Disease process/prognosis, therapeutic regimen,
and limitations understood.
5. Plan in place to meet needs after discharge.
.
NURSING INTERVENTIOS
 preventing injury
 reducing fears of seizure
 improving coping mechanism
 providing patient and family education
 monitoring and managing potential
complications
 teaching patient self-care
MORE INFORMATION
What is epilepsy- Epilepsy is a general term that
includes various types of seizures. Epilepsy is
characterized by unprovoked, recurring seizures that
disrupt the nervous system.
What are seizures? - Seizures (or convulsions) are
temporary alterations in brain functions due to
abnormal electrical activity of a group of brain cells
that present with apparent clinical symptoms and
findings.
What types of seizures are there? - The two
main categories of seizures include partial seizures and
generalized seizures. A partial seizure can evolve to a
generalized seizure.
What types of epilepsy are there? - There are
several types of epilepsy. Epilepsy can be divided into
two broad categories: idiopathic epilepsy and
symptomatic epilepsy.
What're the common types of epilepsy? - The
most common types of epilepsy are absence epilepsy,
temporal lobe epilepsy, frontal lobe epilepsy, occipital
lobe epilepsy, and parietal lobe epilepsy.
What causes epilepsy? - Epilepsy may be caused by
a number of unrelated conditions, including damage
resulting from high fever, stroke, toxicity, or
electrolyte imbalances.
What causes children epilepsy? - There are many
possible causes of epilepsy in children. Seizures in

3. infants and children may be due to birth defects,
difficulties during delivery, or poisoning.
What factors will trigger epilepsy? - The triggers
of epilepsy include inadequate sleep, food allergies,
alcohol and smoking, flashing lights, developmental
anomalies, and brain tumours.
What're the symptoms of epilepsy? - There are
many forms of epilepsy, each with its own
characteristic symptoms. The basic symptom of
epilepsy is a brief and abnormal phase of behavior.
How is epilepsy diagnosed? - Making an accurate
diagnosis is vital in planning the correct treatment to
control seizures. Taking a medical history can help rule
out non-epilepsy conditions.
What're the treatments for epilepsy? - For most
people with epilepsy, treatment can reduce or prevent
seizures and allow many patients to remain free of
seizures for the rest of their lives.
What epilepsy medications are available? -
Epilepsy is often treated with medication,
neurocybernetic prostheses. Medications available for
the treatment of seizures include phenytoin,
carbamazepine, divalproex.
What epilepsy surgeries are available? -
Surgical techniques to remove injured brain tissue may
be appropriate for many patients with epilepsy. The
most common surgery for epilepsy is temporal
lobectomy.
What is vagus nerve stimulation? - Vagus nerve
stimulation is a recently developed form of seizure
control which uses an implanted electrical device.
What epilepsy diet is suggested? - It is believe
that a restricted caloric intake while on a balanced
diet can lead to measurable seizure reduction among
all age groups.
How to prevent epilepsy? - Effective actions for
the prevention of epilepsy include adequate pre-natal
and post-natal care, safe delivery, control of fever in
children, control of parasitic diseases.
Epilepsy in children - Epilepsy is a common
childhood disorder. The prospect of control by means
of anti-epileptic drugs is good in most children with
epilepsy.
Pregnancy and epilepsy - Women with epilepsy
who become pregnant have a higher risk for
complications than women who don't have epilepsy.
Difference between seizures and epilepsy -
Seizures are a symptom of epilepsy. Epilepsy is the
underlying tendency of the brain to produce a sudden
burst of electrical energy.
thank you...