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The epileptic status of grand mal (convulsive seizures). Seizures, unclassified elsewhere


ICD-10 code
The epileptic status of grand mal (convulsive seizures)
G41.0
Seizures, unclassified elsewhere
R56
Diagnostics
When diagnosed

Mandatory
Level of consciousness, pupil size, neurological status, meningeal symptoms, a thorough examination to exclude injury, blood pressure
Laboratory tests: blood glucose, CBS indicators, blood gases, hemoglobin, electrolytes (K, Na, Cl, Mg, Ca), white blood cells, blood count, urea, creatinine

Additional (according to indications)
LP, CT, MRI, toxicological tests (content in ureterubazide, isoniazid)

During treatment
Monitoring according to clause 1.5., Level of consciousness, neurological status, pupil size
Laboratory studies: glucose, determination of CBS parameters, blood gases, electrolytes, diuresis, fluid balance in the subsequent EEG

Treatment
First of all, measures to maintain ventilation of the lungs. If the episode of convulsive activity does not stop within 4 minutes, the administration of anticonvulsants is indicated:
Diazepam 5-10 mg (0.1-0.3 mg / kg) iv for 2 minutes, if there is no effect repeatedly every 10-20 minutes to a total dose of 30 mg in 8 hours, or midazolam 0.2 mg / kg iv in the form of a bolus, a maintenance dose of -0.1-0.4 mg / kg / hour, possibly IM 0.07-0.3 mg / kg;
Phenytoin 18-20 mg / kg - as an IV bolus slowly no more than 50 mg / min (danger of hypotension), maximum dose 30 mg / kg
Phenobarbital - iv 15-20 mg / kg, maximum rate of administration 100 mg / min
IV lidocaine 1.5-2 mg / kg for 2 minutes, again after 5 minutes, maintenance infusion 3-4 mg / min
Propofol IV - bolus 2 mg / kg, maintenance infusion - 0.1-0.2 mg / kg / min (6-12 mg / kg / h), can lead to apnea and hypotension, appropriate respiratory support
Pyridoxine (vitamin B6) - 100 mg iv, in case of isoniazid poisoning, the initial dose is up to 4 g, again 1 g every 30 minutes to achieve a dose equivalent to the amount of isoniazid taken.
In children, the initial dose is 40 mg / kg iv. If there is no effect from the listed measures - general anesthesia with intubation of the trachea, mechanical ventilation and muscle relaxants
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The epileptic status of grand mal (convulsive seizures). Seizures, unclassified elsewhere

  1. Convulsive status epilepticus
    Status is a condition in which seizures follow one after another for more than 30 minutes. The patient does not regain consciousness between seizures, each subsequent seizure begins earlier than the previous one. Epileptic status is an emergency that requires treatment. Without treatment, the status of seizures leads to the death of the patient. Treatment status. The patient is laid on his side
  2. Pulmonary edema with excessive dilution in the alveoli: laryngeal edema. Respiratory conditions caused by unspecified external agents. Adverse effects, unclassified elsewhere. Asphyxia. Choking (by squeezing)
    ICD-10 code Lung edema with excessive dilution in the alveoli: laryngeal edema J38.4 Respiratory conditions caused by unspecified external agents J70.9 Adverse effects, unclassified in other T78 sections Asphyxiation. Choking (by squeezing) T71 Diagnostics When a diagnosis is made Mandatory Level of consciousness, frequency and effectiveness of breathing, heart rate, pulse, blood pressure ECG
  3. Epileptic seizure, status epilepticus
    An epileptic (convulsive) seizure is a nonspecific reaction of the brain to disorders of various nature in the form of partial (focal, local) or generalized convulsive attacks. Epileptic status - a convulsive seizure lasting more than 30 minutes or recurring seizures without full recovery of consciousness between seizures, is dangerous for the patient's life (in adults
  4. Convulsive seizures
    PATHOPHYSIOLOGY A seizure is the result of a paroxysmal neural discharge that causes generalized or focal neurological manifestations. Most generalized seizures begin in the form of a focal cortical discharge and turn into a loss of consciousness with severe muscle cramps. Continuous partial (non-generalized) seizures may not lead to
  5. Epileptic seizures
    The basis of epileptic, or convulsive, seizures is a sharp violation of the electrical activity of the cortex of the cerebral hemispheres. Such a seizure is characterized by impaired consciousness, the appearance of convulsions, and disorders of sensitivity and behavior. Unlike fainting, it can occur regardless of body position; the color of the skin, as a rule, does not change. The so-called
  6. Epileptic seizures
    Epileptic or convulsive seizures are a sharp violation of the electrical activity of the cerebral cortex, which is clinically manifested by impaired consciousness and disorders of movement, sensitivity and behavior. Epileptic seizures of various etiologies, occurring with minimal or even no precursors and leading to short-term loss of consciousness, are necessary
  7. Classification of Epileptic Seizures
    I. Partial (focal) seizures: A. Partial simple: 1. Motive with a march (Jackson), without a march –advertive, postural, speech (vocalization or stopping speech). 2. Sensory (somatosensory, visual, auditory, olfactory, taste, seizures of dizziness of an epileptic nature). 3. Vegetative
  8. The role of brain structures in the formation of epileptic seizures
    Epilepsy is a chronic disease that manifests itself in repeated, convulsive or other seizures, loss of consciousness and is accompanied by personality changes. Epilepsy is primary and secondary. Epileptic syndrome is also highlighted, which is similar to epilepsy. Etiology and pathogenesis have not yet been studied. The basis of the disease is increased convulsive readiness. It is due
  9. Differential diagnosis of epileptic seizures and fainting.
    Fainting should be distinguished from impaired brain activity caused by an epileptic seizure. A seizure can occur day or night, regardless of the patient’s body position; fainting rarely occurs when the patient is lying down, with the exception of attacks of Morgagni — Adams — Stokes. The color of the skin during the seizure, as a rule, does not change, although cyanosis can occur. Pallor -
  10. Status epilepticus
    An epileptic status is diagnosed when: 1) epileptic seizures (see Part I, Seizures) follow each other so often that in between the patient does not regain consciousness (unlike a series of seizures); 2) a single seizure lasts more than 30 minutes. The most common cause of status is a sharp cessation of antiepileptic drugs. Especially high risk
  11. WEAKNESS, Fainting, and Epileptic Seizures
    Raymond D. Adame, Joseph B. Martin (Raymond D. Adams, Joseph B. Martin) Occasional episodes of weakness, a feeling of lightness in the head or dizziness, and a decrease in alertness are often difficult to distinguish, and one type of disorder can go unnoticed into another. Often the difference between a feeling of weakness and a clear swoon is only quantitative. Some varieties of episodic
  12. Relieving epileptic status
    The effectiveness of urgent therapy with status epilepticus directly depends on its early onset and can actually be provided in resuscitation and intensive care units, as well as (if possible) in neuroresuscitation units. In the treatment of status epilepticus in children, diazepam (administered intravenously and / or rectally) and midazolam (administered
  13. Partial epileptic seizures with foci in the primary and secondary cytoarchitectonic fields of GM
    Partial, or focal, epileptic seizures Partial, or focal, seizures begin with the activation of neurons in one local zone of the cortex. Specific clinical symptoms are caused by the involvement of a specific area of ​​the cortex and indicate its dysfunction. Damage can be caused by birth or postnatal trauma, tumor, abscess, cerebral infarction, vascular malformation
  14. Epileptic status: concept, pathogenetic mechanisms, clinical manifestations
    Epileptic status - a condition in which the patient does not regain consciousness between seizures or the seizure lasts more than 30 minutes. Mortality in epilepticus. status in the absence of specialized care up to 50%, with adequate treatment 5-12%. Stop in conditions of resuscitation (the first thing I do is intravenously Relanium). The cause of true status epilepticus is epilepsy.
  15. Features of convulsive seizures in children. Epileptiform sdr.
    EPILEPSY is a chronic brain disease characterized by repeated seizures that result from excessive neural activity and are accompanied by various clinical and paraclinical manifestations. The basis of epilepsy is increased neural activity with high-voltage hypersynchronous discharges (epileptic focus). Most common epileptic seizures
  16. Otitis media in other diseases classified elsewhere. H-67.8
    {foto72} Treatment outcome: Clinical criteria for improving the patient's condition: 1. Normalization of temperature. 2. Normalization of laboratory parameters. 3. Improving the clinical symptoms of the disease (pain, hearing loss, discharge from
  17. Otitis externa in other infectious and parasitic diseases classified elsewhere. H-62.3
    {foto53} Treatment outcome: Clinical criteria for improving the patient's condition: 1. Normalization of temperature. 2. Normalization of laboratory parameters. 3. Improving the clinical symptoms of the disease (pain, hearing loss, discharge from
  18. Otitis externa in other diseases, in other sections. H-62.4
    {foto54} Treatment outcome: Clinical criteria for improving the patient's condition: 1. Normalization of temperature. 2. Normalization of laboratory parameters. 3. Improving the clinical symptoms of the disease (pain, hearing loss, discharge from
  19. COMA, STROKE, CRANISM, AND BRAIN DEATH
    COMA, STROKE, CRIMPAL ACTIONS AND DEATH
  20. Epilepsy. Etiology. Pathogenesis. Convulsive Giving help. Non-convulsive equivalents of epileptic seizures. Twilight stupefaction. Trances. Ambulance
    Epilepsy is one of the most common diseases of the nervous system, which, due to its characteristic features, presents a serious medical and social problem. Among the children’s population, the frequency of epilepsy is 0.75-1%, of which 65% can live without attacks, provided that they undergo an appropriate medical examination and receive appropriate treatment.
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