Has numerous subtypes: GCSE (e.g., persistent, generalized electrographic seizures, coma, and tonic-clonic movements), and nonconvulsive status epilepticus (e.g., persistent absence seizures or focal seizures with confusion or partially impaired consciousness, and minimal motor abnormalities). GCSE is obvious when overt convulsions are present, but after 30-45 min of uninterrupted seizures, the signs may become increasingly subtle (mild clonic movements of the fingers; fine, rapid movements of the eyes; or paroxysmal episodes of tachycardia, pupillary dilatation, and hypertension). EEG may be the only method of diagnosis with these subtle signs; therefore, if a pt remains comatose after a seizure, EEG should be performed to exclude ongoing status epilepticus. GCSE is life threatening when accompanied by cardiorespiratory dysfunction, hyperthermia, and metabolic derangements such as acidosis (from prolonged muscle activity). Irreversible neuronal injury may occur from persistent seizures, even when a pt is paralyzed from neuromuscular blockade.
Section 2. Medical Emergencies