3. 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%. See
Seizure. Cf Serial seizures.