Module 3: Assessment

Lesson 6

Status epilepticus: Comprehensive assessment

General considerations

An emergent assessment of potential precipitating factors of SE occurs simultaneously during stabilization of the patient. For patients with epilepsy, a change in medication is one of the most frequent reasons for an episode of status epilepticus. However, nearly 54% of cases of SE occur without a diagnosis of epilepsy (Betjemann & Lowenstein, 2015).

Acute etiologic processes that can elicit SE include: metabolic disturbances; sepsis; stroke; head trauma; CNS infection (e.g., meningitis, encephalitis, abscess); hypoxia; withdrawal from alcohol, benzodiazepines, or barbiturates; drug toxicity; and non-adherence to anti-epileptic drugs (AEDs).

Chronic processes that predispose patients to SE include: CNS tumours; breakthrough seizures in pre-existing epilepsy; and, chronic alcohol abuse.

For children, prolonged febrile seizures are the most common cause of status epilepticus, with bacterial meningitis and inborn metabolic errors frequent causes of the condition (Brophy et al., 2012).