Management of Status Epilepticus (PART 3)

ANESTHETIC CONSIDERATION IN SE:(1) After all standard therapy has failed or has been determined to have unacceptable side effects most neurology textbooks recomend consulting an anesthesiolo gist for administration of general anesthesia to manage SE.Under these situations what anesthetic should be given ? Unfortunately no controlled clinical studies have been conducted to adequately answer this question. Anesthetic drugs that have been used successfully to stop SE include barbitutates,benzodiazepine,propofol,etomidate ketamine,isoflurane,enflurane,and halothane.  If general anesthesia is needed to manage SE a patient outcome is thought to corelate more with the underlying...

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Management of Status Epilepticus (PART 2)

MANAGEMENT OF TONIC- CLONIC  SE:(1,2) Time from initiation of observation and treatment (min)          Procedure =================================================         0                         Assesss cardiorespiratory function                                    as the presence of tonic clonic sta                                    tus is verified.If ensure of diagnosis          ...

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Management of Status Epilepticus (PART 1)

DEFINITION:(1,2) Status epilepticus(SE) is a condition characterized by an epileptic seizure that are so frequently repeated or so prolonged as to produce a fixed and lasting epileptic condition. Clinically this should be interpreted as any patient who has convulsive activity for more than 30 minutes or who has a 30 minutes of repetitive seizures without rousing to full awareness and clear mental status. The 30 minutes interval has come from recent animal and human studies that show significant neuronal damage occuring after this time. Therefore,to prevent brain damage, seizure should be terminated as soon as possible optimally within 30 minutes of onset. Repeated events...

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Anesthesia For Epilepsi Surgery (PART 5)

ANESTHETIC MANAGEMENT (CONCIOUS ANALGESIA):(1,2,3) One must be assessed the ability of an individual patient to tolerate the procedure awake.There is significant associated discomfort and possibly pain which must be explained very clearly to the patient. In ability to comprehend this (e.g.in mentally retarded  patients or children ) is a relative contra indication to awake craniotomy. The upper airway should be assessed;a patient in whom  difficulty with tracheal intubation is predicted may not be suitable candidate for awake craniotomy because intuba- tion sometimes is needed emergently even with the patient in the akward position required for surgery. Another factor is the...

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