Status Epilepticus in Children

Posted by e-Medical PPT
Status epilepticus is defined as recurrent or continuous seizure activity lasting longer than 30 minutes in which the patient does not regain consciousness.It results from rapid abnormal electrical discharges from cerebral neurons. This presents clinically as involuntary alterations of consciousness or motor activity. Consumption of oxygen, glucose, and energy substrates is significantly increased in cerebral tissue during seizures. Optimal delivery of these metabolic substrates to cerebral tissue requires adequate cardiac output and intravascular fluid volume.
Prolonged seizures are associated with cerebral hypoxia, hypoglycemia, and hypercarbia and with concurrent and progressive lactic and respiratory acidosis. When cerebral metabolic needs exceed available oxygen, glucose, and metabolic substrates (especially during status epilepticus), neuronal destruction can occur and may be irreversible.
Causes of Status epilepticus in Children
Neonates
    * Birth injury (eg, anoxia, hemorrhage) and congenital abnormalities
    * Metabolic disorders (eg, hypoglycemia, hypocalcemia, hyponatremia) and inborn errors of metabolism (eg, lipidoses, amino acidurias)
    * Infection (eg, meningitis)

Early childhood
    * Birth injury
    * Febrile convulsions (3 mo to 6 y)
    * Infection
    * Metabolic disorders
    * Trauma
    * Neurocutaneous syndromes
    * Cerebral degenerative diseases
    * Tumors
    * Idiopathic



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