Status epilepticus (continuous or intermittent convulsions with persisting unconsciousness) may be precipitated by sudden change in therapy, intercurrent infection, trauma or cerebral oedema. It is serious and is often fatal because it causes prolonged anoxia with brain and myocardial damage as well as physical injury. Treatment should maintain normal metabolism, ensure oxygenation, prevent further seizures and finally allow return to consciousness. The first doctor to see the patient should start treatment at once, before sending the patient to hospital, preferably in an ambulance with facilities for oxygen therapy. The respiratory passages must be kept clear and the head kept low; occasionally oxygen and artificial respiration are needed. The precipitating cause of the status epilepticus should be treated and anticonvulsant therapy stabilised later.
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