Case 3.2 Status Epilepticus

Treatment for epilepsy is often focused on controlling the seizures with the least amount of medication as possible. Antiepileptic drugs (AEDs) are the class used to accomplish this. Some of the AEDs that are used most often are Clonazepam, Diazepam, Divalproex, Gabapentin, and Phenytoin. The most common side effects of these medications include nausea, vomiting, sedation, fatigue, and lethargy. (Kwan,1; Benbadis, 3-5; Huethers,637)

The study by Amato, Minozzi and Davoli (2011) examined five randomized controlled trials to find an efficient and safe medication to treat AWS. The study which had a total of 7333 patients concluded that benzodiazepines were better for controlling seizures when compared to a placebo and antipsychotics (Amato et al., 2011). When comparing benzodiazepines versus anticonvulsants, researchers concluded that the benzodiazepine chlordiazepoxide had better outcomes. No other studies were found which would compare the effectiveness among benzodiazepines for the treatment of AWS.

Mrs. Dey reported she had been extremely sick with the anti-seizure medications and her primary care advised her to stop the current medication and go into the hospital. She was hospitalized overnight in observation and Dr. Hardy requested she come into his office the following Monday, September 11, 2017. Due to the unexpected appointment, I had a scheduling conflict and my colleague Laurie Wawrzynaik RN, BSN, MA, attended.

Epilepsy is a medical ailment in which nerve cell activity in the brain is disturbed, causing seizures. Epilepsy consists of many levels of severity; there are staring spells on the lower end, and Grand Mal seizures on the higher end. Cheyenne is on the lower end with staring spells, memory loss, and involuntary talking it’s called Partial Onset Seizures; she has the potential that it can have it turn into Grand Mal seizures at any point in her life. On the path to discovering her epilepsy, it changed her and her family’s lives forever.

Seizure disorders, according to the Mayo Clinic (2015), affect approximately 1 in 26 people in the United States. Persistent, or chronic, seizures result from a condition called epilepsy, a neurological disorder of the central nervous system. It can affect anyone regardless of age, but is more common during early childhood and after age 60. Given the number of people that seizure disorders, such as epilepsy, affect, it becomes helpful to gain a foundational understanding of the disease, including some of the causes, symptoms, and treatments available.

Epilepsy and Seizure Disorder: All actions and functions travel to the different parts of the brain much like electrical wiring. The “electricity” moves from one area or wired circuit through another by jumping and traveling from area to area much like electricity Due to abnormal electricity and “jumping” seizures can occur. Epilepsy is where these electoral abnormalities are reoccurring often causing many seizures. The Tonic-Clonic or Grand Mal seizures that CM has is from muscles tightening and relaxing very fast due to the abnormal jumping of electricity in the brain. P. 417

Tony is a single, 50 year old Caucasian male still living with his mother and has one child which is a daughter 6 years old from a previous relationship in the past. He has never been married and currently not able to drive because of his seizure disorder because in the state of North Carolina he has to be seizure free for 1 year and approved by his family physician to legally drive. He relies on public transportation, friends and his mother in getting different places, such as going to the doctor, and visiting with his daughter. He has supervised visit with his daughter every other weekend due to the safety issues concerning his seizure disorder. Tony cannot be left alone because he does have a history of having seizures while no one is around

The purpose of this study was to find another alternative medication to be used in managing status epilepticus in a hospital setting. This study compared intravenous (IV) valproate and diazepam infusion in patients with status epilepticus (SE). The main goal of this study was to evaluate the efficacy and safety of IV valproate and continuous diazepam infusion as second-line anticonvulsants. Side effects were also evaluated in this study. The major goal from this study was to maintain and terminate the status epilepticus

Epilepsy Research Paper People most often associate violent twitching, falling to the floor and drooling with epilepsy. However the described event is only one kind of an epileptic seizure, which is called a tonic-clonic seizure. There are many other kinds of seizures, and each has different sets of signs and symptoms. During generalized seizures the whole brain is affected and the initial symptom is loss of consciousness. This category includes such seizures as absence seizure, myoclonic seizure, and atonic attack.

Many studies have suggested that managing nonconvulsive status epilepticus (NCSE) presents many challenges, which would benefit from additional early measures to predict patient outcomes. Non-convulsive status epilepticus (NCSE) is status epilepticus without obvious tonic–clonic activity. NCSE is now known to be a heterogeneous disease with a variety of reasons, several subtypes (Shenker and Foundation 2003). In the mental status testing study researcher stated most patient were unexplained reduced level of consciousness or altered mental status and they only administer Folstein Mini-Mental State Examination (MMSE) when patients very mildly impaired. To determine the usefulness of the NCSE divided into Standardize NCSE exam and Glasgow coma

It is significant to treat an individual with status epilepticus as soon as possible. One study indicated that 80 percent of folks in status epilepticus who received medicine within 30 minutes of seizure onset ultimately stopped having seizures, while only 40 percent recovered if two hours had passed before they received medicine. The following medicines may be

Epilepsy is a brain disorder classified as a neurological disorder that affects the brain’s electrical and immoderate activity which causes a person to have a seizure. This brain disorder goes back thousands of years to Ancient Greece where these individuals believed that people had seizures, they were being visited by an evil spirit or demon. The word Epilepsy also derives from the ancient Greek word attack. Ancient Greeks also thought that this neurological disorder, Epilepsy, was infectious and for this same matter most of the people that suffered from this disorder lived alone. Now in present day, researchers and scientist know that this is not true and they now know the real factors and things that cause these seizures to occur.

The patient is a 53-year-old African American female who was recently hospitalized from 1/19 -1/22, had a complete workup for seizure disorder, was discharged home and she represented to the ED several times on the 23rd complaining of seizures. She present after having a single isolated seizure which lasted 20 minutes witnessed by her family. She also presented earlier in the evening of the previous evening because she continued to have seizures. She is a history of CVA, hypertension, bipolar disorder. The patient has required intubation in the past. Her laboratory work is essentially unremarkable, phosphatase of 26, AST of 72 and ALT of 75. Dilantin levels are not reported at this point. The case was discussed with Dr. Amr Kahf. I

ellipse area measured from the SODP of IMFs has been used as a feature in order to discriminate

Partial seizures also referred to as focal seizures, have abnormal excited neuron activity on one part of the brain and in some cases it can increase to other parts of the brain. These specific areas are called the seizure focus. As the activity typically stays around where it started from, there is the potential for it to spread due to the failure of inhibitory mechanisms. Within the seizure focus, neurons experience depolarization, which is then followed by a line of action potentials. The activity involved is defined as proximal depolarizing