Definition: sudden, uncoordinated muscle contractions.

Types: 

• Tonic.
• Clonic.
• Tonic-clonic.

Etiology: 

• Trauma.
• Intoxication, withdrawal syndrome.
• Strokes.
• Epilepsy.
• Infections - CNS infection, febrile seizures in children.
• Metabolic disorders (hypoglycemia, electrolytes disorders...).
• Tumor.
• Hypoxia.
• Congenital disorders.
• Neurodegenerative diseases.
• Idiopathic.

Therapy: 

• Antiseizures-medication - benzodiazepines (initially, 10 mg diazepam IV for an adult), antiepileptic.
• Therapy of precipitating cause.
• Symptomatic therapy during ABCDE approach.

Status epilepticus 

Status epilepticus (SE) = seizures lasting longer than 5 minutes (generalized convulsive) or 10 minutes (focal with impaired consciousness)

Established SE = not terminated with benzodiazepines.

Refractory SE = not terminated with benzodiazepines and two types of antiepileptics.

Therapy: 

1.) ABCDE approach - symptomatic therapy (O2, monitoring: ECG, NIBP, SpO2), IV access, take labs, and start differential diagnosis.

2.) First-line medication: Benzodiazepines - first chose Diazepam IV.

3.) Repeat benzodiazepines.

4.) Second-line medication: first choice antiepileptic - phenytoin, levetiracetam. 

5.) If the seizures still persist, call for help. Experienced physicians should take the next steps.