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Discussion

Question on absence Sz

I had an interesting case last week in the ER. 21 years old lady with HX of epilepsia. Last Sz 6- 1 years ago. Not a very good Hx from fiance cause" just been dating her 6 month ago.But I know for ever !!( ummmmm ) Anyway, withness tonic/clonic lasted 1 min, no incontinence. Ox4 with EMS. Due to our amazing care , therefore been very popular, she had to wait in the hallway with an other medic crew for 2-3 hours. On report they state:"she is kind spaceout". Ask if he notice any abscence or anything, state that he didn't. They also state they had a good visual on her. On assessment. she is oriented x2 1/2. slow to answer and 2 week behing in the time question. She does apear to be in lala land. Apear to belong time to be post-ictal. So send etoh and suspect possible drug on board. at no point she does any absence on me. Dx?? Absence sz therefore possible status epilecticus r/t ongoing absence sz!!!! I always thought absence Sz they would be... absent!! My question ( finally phiposurde, you took your time!!!8) In full status epilecticus tonic/sz we can assess lactate and decrease in sugar. What would be abnormal in her case?? Her sugar was in the normal range by the way(sorry I am not familiar with your number in the USA). Any neuro nerdy outhere??

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What's the EEG like? I know that some EDs would rather fully rely on neuro consult than obtain emergent EEG.

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