USMLE Forum Archives - USMLE Step 2 CK - Status epilepticus
Status epilepticus
mohhaider - 10-06-08 13:33
Hi guys ,
Status epilepticus is a neurological emergency ,After securing the AIRWAY ,BREATHING and CIRCULATION ,How can we manage the patient ?
mohhaider - 10-06-08 13:33
Hi guys ,
Status epilepticus is a neurological emergency ,After securing the AIRWAY ,BREATHING and CIRCULATION ,How can we manage the patient ?
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#1
Re: Status epilepticus usmlefever3 - 10-06-08 13:49 medication should be given which is bezodiazepines
#2
Re: Status epilepticus sackatdoc - 10-06-08 14:06 what we follow here is called step up approach, start with lorazepam or diazepam, if not controlled,phenytoin, still not phenobarbitol, still not midazolam or propofol.
#4
Re: Status epilepticus
mohhaider - 10-06-08 16:39 Yes ,Sackatdoc is right .
But you need after ABC is to look for reversible causes and treat them agressively as epilepsy is treated as a symptom first with many differential diagnosis .
For Epilepsy reversible causes :The VITAMINS mneomonic is used (Except Ideopathic causes that are primary and can cnot find a cause to be treated )
V=vascular like stroke and AVM
I =Infections like encephalitis and meningitis
T=Traume esp. penetrating
A=Autoimmune like CNS vasculitis
M=Metabolic like Hyponatremia ,hypoglycemia ,hypoxia,hypocalcemia ,hypomagnasemia ,adn drug overdose /withdrawl
I =Ideopathic
N=Neoplasms
S=pSychiatry
Hope that I review some notes about Status Epilepticus .
#5
Re: Status epilepticus sackatdoc - 10-06-08 17:15 i object to your "but" here,since the question is status epileticus, that is pt is seizing without gaining alert mentation in between the siezures, so we need not try and find the causes first, cause each episode of seizure means anoxia which brain cannot take so treatment the way i told first, irrespective of the casuse of seizure,of course when you mentioned circulation the withdrawing of the blood has taken place and sample sent to lab, but you dont wait for results to make your diagnosis , you start with lorazepam/diazepam and so on and so forth
#6
Re: Status epilepticus mohhaider - 10-07-08 00:37 I was thinking like you before, then when I read that subject during CK prepartion ,I found the management exactly as I wrote before.Anyway we may try to find the cause as we give the first line drugs .
#7
Re: Status epilepticus sackatdoc - 10-07-08 06:33 yeah,once seizures are under control, your beautiful VITAMINS will help!!!thanks for these vitamins,buddy!
#8
Re: Status epilepticus mohhaider - 10-07-08 14:27 I like using these mnemonics since it is easy to remember them.Yes Sackatdoc investigations should be done with attempts to control seizure immediately.
#9
Re: Status epilepticus sackatdoc - 10-07-08 15:02 my problem is i cant remember mnemonics until and unless they are really making a lot of sense or have a perfect association with the fact, i try reading them but forget them soon, so not able to use in exams.
#10
Re: Status epilepticus neanne - 10-07-08 20:46 
posted by sackatdoc on 10-07-08 15:02
my problem is i cant remember mnemonics until and unless they are really making a lot of sense or have a perfect association with the fact, i try reading them but forget them soon, so not able to use in exams.
my problem is i cant remember mnemonics until and unless they are really making a lot of sense or have a perfect association with the fact, i try reading them but forget them soon, so not able to use in exams.
I have te sme problem Sack...I just make flashcards and read them over and ovet again...
#11
Re: Status epilepticus mohhaider - 10-08-08 02:33 Yes, some of these mnemonics are meaningless ,but they helps especially if you have two groups and need to differentiate them e.g : hepatic enzymes iducers and inhibitors ,AST and ALT elevation in alcoholics Vs viral hepatitis .
#12
Re: Status epilepticus sackatdoc - 10-08-08 05:31 hi neane, you are back?how are you?
right,haider, there is no escape, you have to use them, i like them but just dont work for me.
#13
Re: Status epilepticus mohhaider - 10-08-08 09:07 Yes Sackatdoc ,some of these mnemonics are difficult to remember ,but other you will not forget .Another e.g : Point and Shot mnemonic for Parasympatyhetic and Sympathetic supply of erection and ejaculation .
#14
Re: Status epilepticus sackatdoc - 10-08-08 14:53 what do i say?right now i can say so much but cant.....
#15
Re: Status epilepticus mohhaider - 10-08-08 15:58 Ok ,try to read them with no mnemonics and then Read them again with mnemonics ,you will find them easeir than expected .
#16
Re: Status epilepticus sackatdoc - 10-09-08 03:26 oh HAIDER!!!,you are so innocent, what i was referring to was the mneumonic that you gave example of was too funny and sexual.
#17
Re: Status epilepticus mohhaider - 10-09-08 04:09 I always thinking like that and about the mnemonic ,I found it in high yield neurology for STEP 1 3rd edition .I think you will never forget that .
#18
Re: Status epilepticus sackatdoc - 10-09-08 18:11 no guy can forget that, not sure of the girls!!!sorry for the comment ,pardon me, sometimes to laugh and get dirty doesnt hurt right???
#20
Re: Status epilepticus ammulufy - 06-25-10 23:50 Thnx Mohhaider.....a beautiful MNEMONIC for a very important n serious disorder......
#21
Re: Status epilepticus babbu5508 - 06-26-10 03:53 the benzodiazepine of choice is lorazepam for initial treatment due to its long (2–8 hour) duration of action and rapid onset of action, thought to be due to its high affinity for GABA receptors and to its low lipid solubility which causes it to remain in the vascular compartment.
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