What is included in the workup of status epilepticus (SE)?

Updated: Feb 13, 2018
  • Author: Julie L Roth, MD; Chief Editor: Stephen A Berman, MD, PhD, MBA  more...
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Answer

The approach to potential status epilepticus (SE) should be conducted similarly to that for any self-limited seizure, but clearly in an expeditious fashion. Prompt diagnosis facilitates medical intervention to abort or limit SE.

The workup should include stat laboratory work. Fever should prompt a thorough search for sources of infection, with blood culture and urinalysis. Lumbar puncture (after neuroimaging to rule out potential cerebral herniation) is indicated if a CNS infection is suspected. Fever, stiff neck, headache, and photophobia are signs and symptoms that may suggest such infection.

The risk of lasting morbidity or mortality is usually lower with focal SE than with generalized convulsive SE. This affords extra opportunities to pursue tests that can confirm the diagnosis, reveal associated etiologic processes (some of which may be morbid), and provide insight into fruitful treatment strategies.


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