Case history
Case history
A 45-year-old man who is experiencing homelessness is found unconscious in the street. He appears stiff, with continuously shaking extremities, foaming at the mouth, and urinary incontinence. On arrival at the accident and emergency department, he has stopped shaking but is still unconscious. Stiffening and shaking resume a few minutes later. Two empty medicine bottles are found in his pocket, labelled phenytoin and valproic acid.
Other presentations
Status epilepticus (SE) can vary greatly in its clinical presentation. Patients may present with prolonged periods of confusion, disorientation, memory loss, or personality changes, with no other associated motor manifestations (focal with impaired consciousness SE). Patients may also present with repetitive contraction of a muscle, group of muscles, or an entire limb, with no change of consciousness or awareness, or rarely with only subjective changes or an isolated aphasia (focal without impairment of consciousness SE). This topic focuses on convulsive SE in adults.
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