Seizures – The Resus Room

Seizures are defined as a “paroxysmal electrical discharge of the neurones in the brain resulting in a change of function or behaviour”. All of us involved in Emergency Care will encounter patients with seizures which can occur for a number of reasons, with Epilepsy affecting 1 in 100 people in the UK.

Being able to identify the cause, terminate ongoing seizures and provide ongoing investigation and care is complicated and of paramount importance, as some of these episodes carry with them a high morbidity and mortality rate.

In this episode of Roadside to Resus we run through the following;

The scale of the problem
Causes of seizures
Definition of status epilepticus
Different forms of seizures
Clinical assessment
Investigations
Antiepileptic’s
Management& guidelines; both Pre and In-hospital
RSI for status epilepticus
Follow up and guidance

As always we’d love to hear any thoughts or comments you have on the website and via twitter, and make sure you take a look at the references and guidelines linked below to draw your own conclusions.

Enjoy!

Simon, Rob & James

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References

Distribution of seizure types in an epileptic population. Keränen T. Epilepsia. 1988

Seizures and Epilepsy: An Overview for Neuroscientists. Cold Spring Harb Perspect Med. 2015

Rapid Sequence Termination (RST) of status epilepticus; EMCrit

A comparison of lorazepam, diazepam, and placebo for the treatment of out-of-hospital status epilepticus. Alldredge BK. N Engl J Med. 2001

Refractory status epilepticus: response to ketamine. Sheth RD. Neurology. 1998

Meta-analysis and cost-effectiveness of second-line antiepileptic drugs for status epilepticus. Sánchez Fernández I. Neurology. 2019

Tongue biting in epileptic seizures and psychogenic events: an evidence-based perspective. Brigo F. Epilepsy Behav. 2012