Question 1

no medical hist. developed respiratory prob.viral infect. with headache&vomiting, left facio-brachial seizures that became continuous, evolving into refractory status epilepticus, with bilateralization. tests are fine. now in coma and no diagnostic?

Accepted Answer

Seizures: This sounds like meningitis and encephalitis from an infection. Sometimes there are clues in the complete blood count. Bacterial infections typically show a predominance of neutrophils (also called granulocytes), while viral infections often show a predominance of monocytes or other lymphocytes. Also, if intubated then probably there are sedative medications changing mental status as well.

Question 2

how are serial seizures and status epilepticus treated?

Accepted Answer

Medicine: Mutiple seizures are usually treated with medications. Other options include surgery  bagel nerve stimulation and kerogen oc diet. Status is an emergency condition of a prolonged seizure and require IV medications.

Question 3

can someone tell me what seizures are like in status epilepticus?

Accepted Answer

No recovery  between: Status epilepticus means no recovery between seizures lasting more than 30 minutes---
it could be evident tonic clonic jerking or could be non convulsive status like patient in a non responsive state but not jerking
there is other kinds of status like simple partial.

Question 4

if this is the first time i am having seizures but it lasted more than 30 minutes, is it considered status epilepticus?

Accepted Answer

No: Status by definition involves repetitive seizures without regaining awareness or consciousness between events.  Your episode would include the aura, the seizure itself, and a post-ictal sequence, and your 30 min time frame is unlikely to have been continual seizure activity.  However, your first seizure needs attention, and decisions regarding treatment will be needed.

Question 5

what is the prognosis for status epilepticus? left sided stroke, craniotomy, seizure free first 1 1/2 yrs. 2 seizure meds episodes min 75days apart

Accepted Answer

Status unlikely: Most common cause of status, is abrupt stopping your meds.  The seizures should respond to anti-epileptic meds, but may take a while to get you into an appropriate therapeutic range.   Work closely with your neurologist, and try different meds if seizures continue, but try not to worry, status is unlikely.

Question 6

why would coma induction be used as a treatment for refractory status epilepticus?

Accepted Answer

For brain protection: It is thought that repetitive seizures if not controlled can themselves injure the brain. If the seizures are hard to control it is necessary to give drugs which deeply sedate the patient in order to stop the seizures.

Question 7

name of top surgeon/facility for frontal cortical dysplasia evaluation, treatment and/or surgery?  thank you  e olsen healthy, otherwise normal 16 yr old female, tonic clonic, versive seizures approx 1 x month for 4 years on lamictal.  a few 2 and 3 month

Accepted Answer

The : The best advice to start with would be to ask your neurologist for a neurosurgical recommendation.  They can advise you on a highly-respected neurosurgeon in your area for an evaluation.  As you live in denver, you could also call the university of colorado medical school in denver, ask for the neurology department, and ask for a recommendation.

Question 8

i read that iv lidocaine can be used for refractory status epileptus. i thought higher doses of iv local anesthetics caused seizures?

Accepted Answer

Not exactly: The dose is adjusted to appropriate level to help control the arrhythmias, anesthesia etc. Too high doses can cause seizures

Question 9

can a pet scan diagnose generalized seizures?

Accepted Answer

Not really: Primary generalized seizures would not be expected to change anything on a PET scan. Partial-onset could show an area of altered metabolism. Either way, PET scans are not really a primary way to diagnose epilepsy.

Question 10

after several evaluations i havent received a firm diagnosis of seizure vs. syncope from doctors, including neurologists. how can this be clarified?

Accepted Answer

Witnessed: These are usually not difficult to distinguished if happened several times.However if just happened once or twice and not witnessed or a credible witness can be difficult.An EEG may help for seizure and if can find a  medical reason for syncope with echo,anemia,electrolyte,thyroid,etc may also help.Need a good history with witnesses or video at the time to help.

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Doctor answers about:

Pet refractory seizures presurgical evaluation

A member asked:

No medical hist. developed respiratory prob.viral infect. with headache&vomiting, left facio-brachial seizures that became continuous, evolving into refractory status epilepticus, with bilateralization. tests are fine. now in coma and no diagnostic?

A member asked:

How are serial seizures and status epilepticus treated?

A member asked:

Can someone tell me what seizures are like in status epilepticus?

A member asked:

If this is the first time i am having seizures but it lasted more than 30 minutes, is it considered status epilepticus?

A member asked:

What is the prognosis for status epilepticus? left sided stroke, craniotomy, seizure free first 1 1/2 yrs. 2 seizure meds episodes min 75days apart

A member asked:

Why would coma induction be used as a treatment for refractory status epilepticus?

A member asked:

Name of top surgeon/facility for frontal cortical dysplasia evaluation, treatment and/or surgery? thank you e olsen healthy, otherwise normal 16 yr old female, tonic clonic, versive seizures approx 1 x month for 4 years on lamictal. a few 2 and 3 month

A member asked:

I read that iv lidocaine can be used for refractory status epileptus. i thought higher doses of iv local anesthetics caused seizures?

A member asked:

Can a pet scan diagnose generalized seizures?

A member asked:

After several evaluations i havent received a firm diagnosis of seizure vs. syncope from doctors, including neurologists. how can this be clarified?

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