Abstract
The status epilepticus is being defined as a persistent or recurrent epileptic seizures due to the failure of its terminating mechanisms. In a tonic-clonic seizures, a new consensus has been adopted, that already after 5 minutes it is assessed as the epileptic status and that we may expect long-term sequelae if the activity lasts longer than 30 minutes.
Epileptic seizures can develop in up to 3% of patients with head trauma. If the epileptic status develops, the observed mortality reaches up to 25%.
The basis of the treatment is the airway management, ventilation and stabilization of blood circulation. The medical therapy is initiated by administration of benzodiazepines, the second choice being phenytoin, valproic acid, or levetiracetam.
In refractory epileptic status, propofol is ušed from anaesthetics. In čase of its insufficient effect, it is followed by continuous administration of phenobarbital.
It is always necessary to perform targeted laboratory tests, brain CT scan in čase of head injury, too, while EEG monitoring is advisable. The čase report presents a female patient who developed status epilepticus three hours after a blunt cranial trauma in the home environment without proven loss of consciousness immediately after the injury.
Upon administration of diazepam and levetiracetam, after 25 minutes of the epileptic status, the patient s condition was restored and thus the progression to refractory status epilepticus was prevented.