Most tonic – clonic seizures end after a couple of minutes, when they go on for longer than this and over 5 minutes there is a high risk of Status Epilepticus.
Status Epilepticus literally means a continuous state of seizure. Status Epilepticus is when a seizure lasts longer than 30 minutes or a series of seizures occurs without the person regaining proper consciousness in between.
Tonic- clonic Status Epilepticus is a medical emergency and requires immediate medical attention. During a long convulsive tonic – clonic seizure the body struggles to circulate oxygen around the body. If this happens over a longer period of time it can lead to brain damage and death.
Treatment of Status Epilepticus:
- If a seizure lasts longer than 5 minutes call 999
- Prolonged seizures can be treated with diazepam or bucal midazolam at home however its important to get the person transferred to hospital as soon as possible.
- Wait for help to arrive, use resuscitation if required.
At the hospital:
At the hospital (IV) Intravenous access will be established so that drugs can be given.
An airway will be secured and high oxygen concentration given.
All systems will be assessed.
First line treatment for Status Epilepticus is IV Lorazepam. However if seizures continue IV phenytoin, IV midazolam and proposal can be used.
Seizures should stop however if this does not happen coma is normally induced and the patient taken to intensive treatment unit (ITU) so that the brain can rest.
Once treatment in ITU is stable the patient can be woken and the brain should recover however, assessments will be made as there is a big risk of brain damage at this stage. The mortality rate for Status Epilepticus is 40% .