Different moments and management recommendations for persistent epilepsy

  The different moments and management of persistent status epilepticus are as follows: 0~5 Make a diagnosis of persistent status epilepticus based on persistent convulsions or convulsion reoccurrences. Administer oxygen by nasal cannula or face mask so that the patient’s head is in the best ventilated position; consider intubation if assisted breathing is needed. Regularly record and observe vital signs and correct abnormalities; start cardiac monitoring, establish intravenous access; take venous blood samples for glucose, biochemistry, blood cell analysis, toxicology testing, AED concentration measurement, blood oxygen measurement or regular arterial blood gas analysis.  6~9 If hypoglycemia or blood glucose cannot be measured, glucose can be given. For adults, give vitamin B 1100mg followed by 50% glucose 50ml, intravenous push, and for children, 25% glucose 2ml/kg. 10~20 Give LZP 0.1mg/kg, 2mg/min, intravenous, or DZP 0.2mg/kg, 5mg/min, intravenous. If convulsions cannot be controlled 5 minutes after giving DZP, repeat administration; if convulsions stop, give PHT to prevent recurrence.  21~60 If convulsions persist, give PHT 15~20mg/kg, iv, the rate of administration should not exceed 50mg/min for adults and 1mg/kg/min for children. monitor ECG and blood pressure during administration.  >If convulsions continue, give PB 20mg/kg, iv, at a rate of 100mg/min. If PB is given after benzodiazepines, respiratory depression or asphyxia may occur and assisted ventilation is required. If convulsions persist, give anesthetic doses of drugs such as PB or thiopental sodium. Assist ventilation with intravascular pressure injection of drugs if necessary.