Joan J. Fuller
Status Epilepticus: A Serious Brain Disease?
The term “epilepsy” is not used very often anymore, but it still means something to many people. There are several types of epilepsy; however, the most common type is called “status epilepticus.” Status epilepticus is a rare form of epilepsy that affects only one percent of all patients with epilepsy.1
Status epilepticus is characterized by sudden onset seizures without any known cause or trigger. The seizures can sometimes last from just a few minutes to several hours without stopping.
During this time, an individual with status epilepticus may lose consciousness or have a clouding of their mental state.2,3
In the past, people used to believe that status epilepticus was an incurable disease. Fortunately, this is not true any longer.
In fact, there are several treatment options available for people who suffer from status epilepticus. These treatment options can usually stop the seizures within a short period of time. People who have had status epilepticus in the past are also more likely to have another type of seizure in the future.5,4
What Are the Causes of Status Epilepticus?
There are many types of triggers that can potentially lead to status epilepticus. These triggers can be divided into two main groups: external and internal.
External triggers:6
Alcohol use
Fever or high temperatures
Infections, such as meningitis or encephalitis
Low blood sugar (hypoglycemia)
Marijuana use
Stress
Sugar or chocolate
Being injured or subject to a stroke
Internal triggers:
Underlying brain disorders, such as strokes, tumors or brain damage
Low blood levels of the brain’s inhibitory neurotransmitter (GABA)
What Are the Status Epilepticus Signs and Symptoms?
The status epilepticus signs and symptoms are quite easy to spot if you know what you are looking for. If you think that someone may be suffering from this type of seizure, you should call emergency services immediately. The following are the status epilepticus signs and symptoms to look for:
Confusion
Convulsions
Drooling or difficulty swallowing
Inability to communicate or interact with others
Loss of control of their muscles
Loss of consciousness
Repetitive movements or actions (like chewing or rocking)
Unusual sleepiness or drowsiness
How Is Status Epilepticus Diagnosed?
The good news is, status epilepticus is very easy to diagnose. In most cases, the symptoms are very obvious and there is little doubt that an individual is suffering from this type of seizure.
A number of tests may be performed to rule out other potential causes for the seizure activity. These tests may include:7
Blood tests to rule out other medical causes
CT scan, which can outline any potential brain abnormalities
EEG to monitor brain activity
Lumbar puncture (spinal tap), which can detect any infections or meningitis
How Is Status Epilepticus Treated?
Again, fortunately, there are many treatment options available for status epilepticus. The goal of treatment is to stop the seizures as quickly as possible. Treatment can include one or more of the following:
Benzodiazepines, such as diazepam, which are sedatives that can stop seizures by increasing the brain’s inhibitory activity
Anticonvulsants, such as phenytoin or valproate, which work by decreasing the excitability of nerve cells
A combination of both benzodiazepines and anticonvulsants
Hospitalization and close monitoring
A procedure to insert a probe into the brain, which can stop the seizures by electrically stimulating the brain
If someone experiences status epilepticus as the result of taking an illegal drug, they may require additional treatments to counteract the drug’s effects.
Outlook
Fortunately, people who suffer from status epilepticus have a very good chance of making a full recovery. In most cases, people who experience status epilepticus due to a brain injury fully recover and never experience another seizure.
People who experience status epilepticus as the result of a brain tumor or another type of brain abnormality may continue to have seizures even after treatment. However, this type of treatment can greatly increase the likelihood of a full recovery.
If you or a loved one is suffering from status epilepticus, do not hesitate to seek emergency medical treatment immediately. Early treatment can make all the difference.
Seizure first aid
How to help someone having a seizure
Most seizures only last a few minutes and the person recovers completely. During this time, it’s important to keep the person safe from injury.
It is also important to try to remember what triggered the seizure, as this may help with diagnosis.
When to get medical help
Seizures that last longer than 5 minutes
Breathing problems
Injury caused by the seizure
Frequently asked questions
Why does this happen?
There is often no clear reason why a person develops epilepsy. Certain factors, however, can trigger the condition, such as:
Head injury
Infections
Low blood sugar
Stroke
Genetics
Alcohol or substance abuse
How is epilepsy diagnosed?
The first step to diagnosis is keeping a diary of when the seizures occur and what triggers them. Your doctor may also suggest keeping a food diary to see if there are any connections to your condition.
A physical examination may also be performed, and your doctor may order blood tests to rule out other medical conditions. Finally, an EEG may be performed to measure your brain’s activity.
How is epilepsy treated?
Treatment for epilepsy most often involves medication. The type of medication prescribed will depend on the type of seizures you have, and may require a combination of different drugs.
Depending on the severity of the condition, other treatment options may be recommended as well, such as surgery or special diets.
Sources & references used in this article:
- Status epilepticus: risk factors and complications (NB Fountain – epilepsia, 2000 – Wiley Online Library)
https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1528-1157.2000.tb01521.x - Risk factors for complications of drug-induced seizures (JG Thundiyil, F Rowley, L Papa, KR Olson… – Journal of Medical …, 2011 – Springer)
https://link.springer.com/content/pdf/10.1007/s13181-010-0096-4.pdf - Risk factors for fatality and neurological sequelae after status epilepticus in children (Y Maegaki, Y Kurozawa, K Hanaki, K Ohno – Neuropediatrics, 2005 – thieme-connect.com)
https://www.thieme-connect.com/products/ejournals/abstract/10.1055/s-2005-865611
