Question

Discuss the medical management of status epilepticus.

Why is it considered a medical emergency?

What education could be given to patients with epilepsy?

Describe the pharmacologic treatment of increased intracranial pressure (ICP).

What is the use and purposes for mannitol (Osmitrol) in the treatment of increased ICP?

A patient has visual and auditory agnosia.

Which of the cerebral areas are affected?

What cerebral area would be affected by tactile agnosia?

What cerebral area would be affected by body parts and relationships with agnosia?

Answer 1

Ans) The treatment of status epilepticus involves the use of potent intravenous medications that may have serious adverse effects. Therefore, the first step in managing the condition is to ascertain that the patient has tonic-clonic status epilepticus, and that prolonged or repetitive seizures have occurred.

- Status in a tonic clonic seizure is a medical emergency and the person will need urgent medical help. Status epilepticus both kills neurons and also leads to chronic epilepsy, neuronal death has been proposed to be an integral part of acquired epileptogenesis.

It is important to call for an ambulance if the seizure goes on for more than 5 minutes. Somepeople are prescribed emergency medication, either buccal midazolam or rectal diazepam, to stop their seizures.

- People with epilepsy should wear Medic Alert bracelets or necklaces identifying their condition and the medications that they take. This will help first responders provide prompt care in the event of an emergency.

You may be able to prevent seizures by avoiding the triggers that cause it. It can be helpful to manage stress, avoid alcohol and drugs, and get plenty of sleep.

You are at risk for accidental injury during a seizure episode. Your doctor can help you determine activities that you may need to avoid, such as driving, climbing, and swimming. You should instruct your friends, family, and coworkers regarding what they should do if you have a seizure.

If you witness someone having a seizure, call for medical help. You should help the person lie down on his or her side, and clear away nearby objects. Place a pillow or soft support under his or her head. Check for a Medic Alert bracelet. Stay with the person until medical help arrives so that you can provide details about the episode.

- Medical management of increased ICP should include sedation, drainage of CSF, and osmotherapy with either mannitol or hypertonic saline. For intracranial hypertension refractory to initial medical management, barbiturate coma, hypothermia, or decompressive craniectomy should be considered.