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Status Epilepticus Pharmacotherapy Guide

 • Phenytoin and Fosphenytoin
 • Valproate Sodium
 • Levetiracetam
 • Lacosamide
 •
Status Epilepticus ... theABofPharmaC #Status ... #Epilepticus #Pharmacology ... #neurology #management ... #epilepsy #seizure
Altered Mental Status - Differential Diagnosis
 • Neurologic: Stroke, Cerebral hypoxia, Cerebral hemorrhage, Seizure, Trauma, TBI,
Altered Mental Status ... Differential Diagnosis • Neurologic ... Cerebral hemorrhage, Seizure ... encephalopathy, Hypoglycemia ... Insomnia, HTN, PRES
Posterior Reversible Encephalopathy Syndrome (PRES) - Diagnosis
Clinical Features:
 • Altered mental status (Either lethargy, confusion, or
Encephalopathy Syndrome (PRES ... Altered mental status ... agitation) • Seizures ... Immunomodulatory meds ... Syndrome #Diagnosis #Neurology
Posterior Reversible Encephalopathy Syndrome (PRES) Overview

Clinico-Radiological Syndrome, characterized by:
 • Headache
 • Seizures
 • Altered mental
Altered mental status ... Altered mental status ... may precede the neurologic ... : Treat with AEDs ... diagnosis #management #neurology
Differential Diagnosis: New-Onset Seizure in the Elderly

STRUCTURAL:
 • Stroke/TIA, Subdural hematoma, mass
 • Traumatic Brain Injury
Diagnosis: New-Onset Seizure ... Hypocalcemia • Hypoglycemia ... increased risk of epilepsy ... (PNES): Behavioral ... #Elderly #Neurology
Management Algorithm for Status Epilepticus

• Assess airway, breathing, and circulation
• Pulse oximetry
• Electrocardiogram
• Finger stick (give
Algorithm for Status ... Management #Algorithm #Neurology ... #pharmacology # ... dosing #seizure
Medications Used in the Abortive Treatment of Ongoing Seizure Activity in the Emergency Department

INITIAL THERAPY
 -
Treatment of Ongoing Seizure ... #Abortive #Seizure ... #Medications #Neurology ... #Pharmacology # ... Dosing #Table
Concentrated Insulin

Developed with the goal of easing therapy by reducing the volume & number of injections
lesser risk of hypoglycemia ... • Available in pens ... lower risk of dosing ... control comparing pre ... Concentrated #Insulin #pharmacology
MGH Status Epilepticus Treatment Protocol
1st line (seizures ongoing for 5-10 mins): 
 - Lorazepam 4mg IV
MGH Status Epilepticus ... Protocol 1st line (seizures ... -30 mins) - If seizures ... min (need EKG pre ... Protocol #algorithm #neurology