Status Epilepticus

Status Epilepticus

Basic Science and Pathophysiology

Incidence of SE

Clinical Assessment and Risk Stratification

4 Topics

Procedure Management

3 Topics

Status Epilepticus

Status Epilepticus

Status Epilepticus Status Epilepticus

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Question 1 of 10

1. Question
1 point(s)
Which of the following statements concerning status epilepticus (SE) is correct?
- Hypotension is common during the early stages of SE, but blood pressure commonly rises as the seizure continues
- An acidosis is commonly seen in SE having both metabolic and respiratory components
- A neutrophil leukocytosis in conjunction with the presence of white cells in the CSF suggests an infective aetiology
- The use of the drug phenobarbitone is associated with a high incidence of visual field defects
Question 2 of 10

2. Question
1 point(s)
Which of the following is not necessarily within the definition of status epilepticus?
- A single seizure that persists for 30 minutes or more
- Multiple seizures occurring without full neurological recovery in between
- a single seizure that persists beyond five mins but less than 10mins
- A single seizure that persists for longer than one hour
- A seizure that fails to respond to 2 doses of IV medication
Question 3 of 10

3. Question
1 point(s)
Which of the following is not a recognised consequence of status epilepticus?
- Tachycardia
- Mixed metabolic and respiratory alkalosis
- Hyperglycaemia
- Altered level of consciousness
Question 4 of 10

4. Question
1 point(s)
Which of the following statements regarding the investigation of patients with SE is correct?
- A normal EEG excludes the diagnosis of SE
- An urgent EEG should be requested
- Blood sugar should be checked in all patients
- A CT scan of the brain is rarely indicated
Question 5 of 10

5. Question
1 point(s)
A known epileptic presents in SE. Which of the following statements regarding his management is correct?
- A persistent metabolic acidosis mandates consideration of treatment with an infusion of 1.26% sodium bicarbonate solution
- Benzodiazepines exert their action by suppressing the focus of a seizure
- Rectal diazepam will be effective in terminating recurrent seizures in 70% of patients with SE
- Studies have demonstrated phenytoin to be the most effective drug for terminating seizures
- The use of fosphenytoin, the precursor of phenytoin, may be associated with the ‘purple glove syndrome’
Question 6 of 10

6. Question
1 point(s)
Regarding the use of benzodiazepines in the management of SE, which of the following is the INCORRECT statement?
- High lipid solubility accounts for a rapid onset of action
- Most patients requiring pharmacological intervention to terminate their seizure require two doses of intravenous diazepam
- Lorazepam has a longer duration of action than diazepam giving it a far longer anticonvulsant effect
- If diazepam is unavailable, lorazepam may be used equally effectively via the rectal route
- Intranasal midazolam is as effective as rectal diazepam at terminating seizures in children
Question 7 of 10

7. Question
1 point(s)
Considering the patient with generalised convulsive SE, which of the following is correct?
- Benzodiazepines are the first line drugs and should be given rectally or intranasally if IV access is not promptly achieved
- Rectal barbiturates should be used first line whilst IV access is being established
- Propofol should not be used in adults or children
- Paraldehyde may be given intravenously if other agents fail to terminate the seizure
Question 8 of 10

8. Question
1 point(s)
Considering refractory SE, which of the following statements is correct?
- SE cannot be said to be refractory until one hour of optimal management has failed to terminate seizures
- Correction of acidosis is an important step in terminating seizures
- Intravenous propofol may be used
- A lorazepam infusion may be used
Question 9 of 10

9. Question
1 point(s)
Which of the following is false regarding investigations in SE?
- A CT brain may be required
- Blood glucose should be checked in all patients
- High blood white cell count indicates that infection is the cause of SE
- Electrolytes including sodium, calcium and magnesium should be checked
Question 10 of 10

10. Question
1 point(s)
A 24-year-old known epileptic is brought to the ED having had multiple brief seizures, each lasting less than two minutes. Just before arrival, he had a further seizure and is still fitting on arrival.

Which of the following statements about his condition and management is correct?
- Phenytoin is more effective than lorazepam for the termination of seizures
- Pharmacological therapy is not necessary because his seizures are short duration
- The majority of patients with SE will have pre-existing epilepsy
- His presentation is in keeping with a diagnosis of SE
- Failure to establish intravenous access mandates attempts at intraosseous access

5 Comments

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jassimg6284 June 20, 2017 at 12:52 am

very useful

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alimunawwark803 November 28, 2017 at 11:36 am

wounderful reall, because this seems interactive and keep us like we are manging a real patient in emd

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Dr. Fadl Ali Al-Tairy September 29, 2020 at 5:33 am

good review topic

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Kirsty Lyon-Taylor November 17, 2020 at 7:18 pm

A useful review of status

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Dr. Jumaan Salim Musallam Bin Madi May 8, 2021 at 9:24 am

Very useful.

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