Signs

Phase I:

• Generalized convulsions

• Hypertension, tachycardia

• Fever and sweating

• Muscle contractions, spasms

• Respiratory compromise

• Incontinence

Phase II (greater than 30 minutes of SE):

• Respiratory failure with pulmonary edema

• Cardiac failure (arrhythmias, shock)

• Hypotension

• Hyperthermia

• Rhabdomyolysis and multiorgan failure

Laboratory Tests

• Hyperglycemia (phase I) and hypoglycemia (phase II) can occur

• Hyponatremia, hypernatremia, hyperkalemia, hypocalcemia, hypomagnesemia, and hypoglycemia can cause SE

• The WBC count may slightly increase

• Abnormal ABGs due to hypoxia and respiratory or metabolic acidosis

• Elevated serum creatinine will be present in renal failure patients

• Myoglobinuria can occur in patients with continuous seizures

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