Generally seizures tend to last for about 2 minutes. But status epilepticus (SE) is a condition where people have continuous or sometimes rapid seizures for a period of 30 minutes and more. The literal meaning of status epilepticus is a state of seizure that is continuous. If one seizure lasts for nearly 5 minutes it is a symptom of status epilepticus and is a serious condition. Whenever status epilepticus occurs it becomes a condition which requires immediate medical supervision. The mortality rate is very high in people who suffer from this condition. Some treatments or therapies for status epilepticus emphasize on reducing it instead of trying to end the seizures completely.
There are mainly two types of status epilepticus- mainly convulsive and non-convulsive. The Convulsive type is very common and the most dangerous of the two. It includes seizures that are tonic-clonic where there is a stiffening of the muscles and the person having it loses his/her consciousness coupled with jerking movements. In non-convulsive status epilepticus a person doesn’t lose their consciousness but go into a state of epileptic twilight. There is clouded consciousness. About 25 % of people who suffer from epilepsy are prone to have SE attacks. And 15 % of these people will have one SE attack at some point or the other in their lives. Children below the age of 15 years and adults above the age of 40 years are susceptible to having a status epilepticus attack.
when treating a loved one suffering from status epilepticus it is imperative that the drug being administered is effective enough to stop the seizures from taking place and the method of delivery of the medication is reliable and easy so that the drug can easily get inside the brain and blood stream and start its work.
The different kinds of medications for status epilepticus includes intranasal, intramuscular and intrapulmonary. In the intranasal method the medications such as midazolam or diazepam can be easily administered and are easily and quickly absorbed into the body. Diazepam, especially is being further tested in laboratories for the possible treatment of cluster seizures which are very high in magnitude. In the intramuscular method the drugs can be quickly administered but the rate of absorption is a bit unreliable as it varies. This method also poses a threat of complications at the site of injection. In the intrapulmonary method after the administration of the medications it gets quickly absorbed into the pulmonary capillaries which get into the heart by way of direct flow in the brain. This is a quick route. However, there aren’t any drugs available in the market as of yet that can be quickly absorbed into the lungs, and researches are trying to see if the existing ones can be modified for easy absorption into the lungs while still having their impact on seizure control.
Everyone is eligible to undergo treatment for status epilepticus however, you need to be a minimum of 2 years. Patients who are having seizures for a minimum of 5 minutes or more are diagnosed with status epilepticus and need immediate medical attention.
Children below the age of two years are not-eligible to go for treatment of status epilepticus.
After your seizures have been controlled or stopped and you have received the required treatment it is essential that you adhere to certain post-treatment guidelines in order to prevent any future seizures from occurring. In order to maintain stable conditions you should get blood cultures done from time to time. A lumbar puncture or spinal tap procedure should be carried out in order to keep in check any possibility of infections or subarachnoid haemorrhage. If you have already been diagnosed with an infection then you need to take empirical antibiotics. Anticonvulsants should be maintained regularly and adjusted from time to time depending on the serum level fluctuations. These adjusted anticonvulsants should be administered accordingly.
The time taken to recover from a status epilepticus treatment is proportional to the duration of the attack. If SE can be effectively halted in a short duration of time then it is possible that a full neurological recovery will be successful. There are high chances of causing serious cerebral damage if the seizures continuous to go on for longer durations.
The cost of treatment for Status Epilepticus including any surgery and medications ranges from about Rupees 1600- 574,000 in India. However, the direct cost of SE is about Rupees 19,000.
If patients adhere strictly to the guidelines and regularly take their medications on time their epileptic condition can be stabilized and a possible status epilepticus can be prevented.