Clinical Symptoms

Patients with SE usually present with generalized, convulsive tonic-clonic seizure activity that is unresponsive to initial AED treatment. They may also be hypertensive, tachycardic, febrile, and diaphoretic; however, these symptoms will resolve soon after the seizure is terminated. A loss of bowel or bladder function, respiratory compromise, and nystagmus may also be observed. When seizure activity is sustained for more than approximately 30 to 60 minutes, muscle contractions may no longer be visible, but the patient remains in SE. Twitching of the face, hands, or feet may be seen in these comatose patients with prolonged seizures. As motor signs diminish, an EEG will be necessary to diagnose SE.

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