Laboratory Parameters

^^ It is important to obtain a serum chemistry profile to help identify the underlying cause of SE. Abnormalities that can cause seizures include hypoglycemia, hyponatremia, hypernatremia, hypomagnesemia, hypocalcemia, and renal and liver failure. In a febrile patient with an elevated white blood cell count (WBC), an active infection should be ruled out or treated appropriately. Cultures from the blood, cerebrospinal fluid (CSF), respiratory tract, and urine should be obtained once the seizures are controlled. CT or MRI can be done to rule out CNS abscesses, bleeding, or tumors, all of which may be a source for seizure activity. A blood alcohol level and urine toxicology screen for drugs of abuse should also be conducted to determine if alcohol withdrawal, illicit drug use, or a drug overdose could be the underlying cause of SE. Also, drug levels should be obtained in a drug overdose situation to rule out toxicity as a cause of SE. Knowing the source of SE will help guide the initial antiepileptic therapy and increase the probability of halting seizure activity.

In patients who use AEDs, a baseline serum concentration may be useful to determine if the drug concentration is below the desired range and if a loading dose is needed. Albumin levels, renal function tests, and liver function tests can also be utilized when assessing antiepileptic therapy.

Hypoxia and respiratory or metabolic acidosis are common in patients with SE. Therefore, pulse oximetry and arterial blood gas (ABG) measurements are used to assess respiratory status and determine if airway protection or supplemental oxygen is needed. Metabolic acidosis typically corrects on its own after seizure activity stops, so pharmacologic treatment is not required.

Alcohol No More

Alcohol No More

Do you love a drink from time to time? A lot of us do, often when socializing with acquaintances and loved ones. Drinking may be beneficial or harmful, depending upon your age and health status, and, naturally, how much you drink.

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