• Epilepsy
    • 2 or more seizures unprovoked by any immediately identifiable cause
    • Causes
      • Metabolic
        • Hyper/hypo-calcaemia
        • Hypomagnesaemia
        • Hyper/hypo-natraemia
      • Genetic
      • Tumour
      • Infection
      • Cerebral degeneration (AD, multi-infarct dementia)
      • CVD
      • MS
      • Alcohol
    • Ix
      • MRI, CT, EEG, SPECT, PET
    • Status epilepticus (paeds)
      • First line
        • Lorazepam 0.1 mg/kg or diazepam 0.5mg/kg PR
        • Rectal paraldehyde 0.4mg/kg if no IV access after 10 mins
      • 15mg/kg phenytoin
      • Paeds
        • Phenobarbital 20mg/kg if on phenytoin
        • GA with 4-5mg/kg thiopentone, 0.1mg/kg midazolam bolus then 2-10μcg/kg/hr infusion
    • Considerations
      • Avoid epileptogenic drugs
      • Look for associated conditions
      • Continue anti-epileptics where possible
      • D/w neurologists
    • Epilepsy surgery
      • Electrode placement via burr hole
      • Cortical speech mapping
      • Cervical vagus nerve stimulation
    • Complications
      • CNS
        • Oedema
        • Hypoxia
        • Haemorrhage
        • Venous thrombosis
      • CVS
        • Mi
        • Hyper/hypo-tension
        • Arrhythmias
      • Resp
        • Pneumonia
        • Apnoea
        • Respiratory failure
        • Pulmonary oedema
      • Metabolic
        • Hyponatraemia
        • Hypoglycaemia
        • Hyperkalaemia
        • Acidosis
        • ATN
        • Hepatic necrosis
      • Misc
        • DIC
        • Rhabdomyolysis
        • Fractures
    • CEACCP
      Link:ceaccp.oxfordjournals.org/content/5/4/118.full.pdf