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Epidemiology The estimated incidence of 35 per 100,000, more common in poorer populations 1. For someone who has seizures, they’re normally similar in length each time they occur and typically stop once that time period has passed. It is a clinical emergency associated with high morbidity and mortality. Status epilepticus (SE) is a very severe type of seizure. Operational definition-either continuous seizures for 5+ mins or 2 or more discrete seizures without complete recovery of consciousness Etiology-acute Metabolic defects–eg, electrolyte imbalances, renal failure, sepsis, CNS infections, strokes, head trauma, drug toxicity, hypoxia Etiology-chronic Preexisting epilepsy where SE is due to breakthrough seizures or discontinuation of antiepileptics chronic alcohol abuse or tumors or stroke Clinical Initially, Pts are unresponsive and have obvious tonic, clonic, or tonic-clonic movements of the extremities with time, the clinical findings become more subtle, and require EEG confirmation Management Airway control, monitor vitals–temperature, pulse oximetry, monitor cardiac function, measure glucose, administer thiamine and glucose, begin anticonvulsants Management-anticonvulsants Benzodiazepines–eg, lorazepam, et al, if no response–INR → phenytoin or fosphenytoin, INR → repeat phenytoin or fosphenytoin, INR → phenobarbital, INR → repeat phenobarbital, INR → anesthesia with midazolam or profonol, INR, inter Mortality ± 20%. Status epilepticus is an acute and prolonged seizure that persists for a sufficient length of time or is repeated frequently enough that recovery between attacks does not occur. STATUS EPILEPTICUS (SE) is a life-threatening condition that affects 120 000 to 200 000 people annually in the United States.