Seizures and Status Epiliepticus by Oli Flower

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OLI FLOWER

WHEN THE SEIZURE DOESN’T STOP

HISTORY

IF THE POSSESSING DEMON…IT MAY GO ON FOR SOME TIME, BUT HE WILL DIE

HIPPOCRATES: “SACRED DISEASE” ORGANIC

BUT CAUSED BY PHLEGM FLOWING OUT OF BRAIN…

SEIZURES ARE A SIGN OF WITCHCRAFT

200,000 WOMEN MURDERED

CHIPAYA PEOPLE: WITCHCRAFT STILL TO BLAME

EPILEPSY, PSYCHOSIS, MELANCHOLY & THOSE WHO HAD CHILDREN OUT OF WEDLOCK

KBr

1912: PHENOBARBITOL

1924: BERGER INVENTS EEG

1938 PHENYTOIN

1965 CARBAMAZEPINE

1967 VALPROATE

1960 ETHOSUXAMIDE

1963 DIAZEPAM

1980 + >20 MORE

MANAGEMENT

X

X X

X X X

WATCH OUT FOR PNES

GLUCOSE

SPEED POWER TIMING

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TIER 1 BENZO + PHENYTOIN*

[*FOR NOW]

8 BABOONS DONATE THEIR BRAINS

THALAMUS HIPPOCAMPUS NEOCORTEX

OBJECTIVE DAMAGE IN 30 MINUTES

TIER 1I MIDAZ + PROPOFOL + X ETT + cEEG

TIER 1II VALPROATE / LEVETIRACETAM / LACOSAMIDE / KETAMINE / Mg2+ / LIGNOCAINE / VERAPAMIL

TIER IV THIO / HYPOTHERMIA ECT / SURGERY

PROGNOSIS

WITHDRAWAL FROM EPILEPSY MEDS

ALCOHOL RELATED

INTRACRANIAL CATASTROPHES

35F NON CONVULSIVE STATUS ANTI NMDA RECEPTOR ENCEPHALITIS IN THIO COMA FOR 5 MONTHS

83F LARGE ICH ON WARFARIN REFRACTORY STATUS ON 3 AED’S

23M VIRAL MENINGOENCEPHALITIS 105 DAYS IN ICU, 9 AED’S LOW GCS, TRACHE, PEG, INCONTINENT

SPEED POWER TIMING

TREAT THE

CAUSE

AGE CAUSE

PREDICT