Published Jun 15, 2007
phiposurde
120 Posts
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??
Jennifer, RN
226 Posts
I'm really not sure what your question is, but, it seems like you think that absence seizures (or petit mal) are undetectable by observing the pt. My son has absence seizures and his are manifested by his eyes slightly rolling up and staring spells lasting ~2-10 seconds, with no loss of motor coordination. These seizures come anytime, sometimes dozen within 1 hour, more so after waking up from bedtime or nap. They can interrupt laughing, talking, etc... and he returns to his normal self immediately with no post ictal state. With direct observation of his face and eyes, they are easily recognizable. He started having these seizures at about 10 months of age, and they are much less pronounced if not completely gone now(at age 4). I don't know if that helps.
Larry77, RN
1,158 Posts
Wow...to the OP...it is very difficult to read your post d/t all the typo's etc...are you French? I don't really understand your question so am unable to answer it but please run spell check for us...thank you.