I have seen patients in subclinical status on several occaisions.
These have had grandmal fits and are now clambering around in a
confused state, unable to communicate and often with dilated pupils
I have not had the luxury of an EEG but would like to have seen one.
They went off to sleep with a further benzo dose and woke up like a
standard fit later on
Andy Volans
Consultant A&E Scarborough
>Ive recently had some experience with trialling a 6 lead EEG as a module for
>one of our monitoring systems. What has surprised me the most has been the
2
>cases in whom the fitting had stopped and they were deemed to be post-ictal
>by our assessment - EEG showed continuing seizure activity which persisted
>for prolonged periods - arrested in one case by further midazolam and the
>other by phenytoin loading. Id be interested in anyone elses experiences
>with this sort of clinical dissociation - Ive come accross it before in
>patients with persisting reduced GCS post seizure but these were all 30-60
>minutes down the track - but it was startling to see it in the early "
>post-ictal " phase.
>
>Craig
>
>
>>From: Danny McGeehan <[log in to unmask]>
>>Reply-To: The list will be of relevance to all trainees including
>> undergraduates and <[log in to unmask]>
>>To: [log in to unmask]
>>Subject: Re: refractory seizures
>>Date: Sun, 11 Mar 2001 00:55:59 -0000
>>
>>I use heminevrin or chlormethazole. I titre the dose and find it very
>>quick
>>and safe. I give IV bolus and then start and infusion.
>>Danny McGeehan
>>
>
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