Outline your principles of management of status epilepticus.
Diagnosis: status epilepticus as > 5 minutes generalised convulsive, non-convulsive, (no return of consciousness), simple partial [Definition 2 or more convulsions with no recovery in between, or continuous convulsion > 30 min (alternative more recently accepted definition is > 5 min)]
Support: Airway, Breathing, Circulation.
Control: using hierarchy of drugs: benzodiazepine (midazolam) + phenytoin loading, propofol, barbiturate (phenobarbitone loading, thiopentone infusion), isoflurane, others. EEG to confirm, avoid paralysis.
Restore: therapeutic prophylaxis drugs if appropriate - check levels. Consider add newer generation agent in difficult cases.
Look for and treat cause:
History of epilepsy, Anti-convulsant compliance, Check and correct biochemical disturbance eg Na
(appropriate speed), hypoglycaemia, low Ca++, severe azotemia.
Look for toxins (TCA, theophylline, amphetamine and other recreational drugs, salicylate, glycols, alcohols, hydrocarbons etc).
Diagnose infective, hypoxic, vascular, metabolic or structural (trauma, neoplasm), physical(hyperthermia) cause - CT, LP, MR, porphyrins.
Treat CNS viral and bacterial infection empirically until excluded. Eclampsia specific management including LSCS, Mg, BP control.
Don't forget factitious epilepsy - look for atypical features, check lactate, EEG, reflexes etc. Consider drug withdrawal.
Treat complications - aspiration, rhabdomyolysis, hyperthermia.
Its another one of those.
Related content would consist of the following chapters:
Chapter 49 (pp. 549) Disorders of consciousness by Balasubramanian Venkatesh
Chapter 50 (pp. 560) Status epilepticus by Helen I Opdam
Brophy, Gretchen M., et al. "Guidelines for the evaluation and management of status epilepticus." Neurocritical care 17.1 (2012): 3-23.