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Does continuous seizure activity cause nervous system damage?
Certain seizure types, such as absence seizures, are not known to have any significant sequelae. In other settings, after a certain duration of epileptiform activity, there may be irreversible neuronal loss.
A number of mechanisms probably mediate this neuronal death, including calcium loading of neurons and excitotoxicity produced by excessive glutamate release.
Because continuous seizure activity can cause neuronal death, it is important to monitor the patient’s EEG during the treatment of status epilepticus, particularly if the patient is paralyzed by neuromuscular blockade.
It is also important to try to prevent any neuronal death by controlling the patient’s status within the first 60 minutes after seizure onset.
Sources
Millikan D, Rice B, Silbergleit R: Emergency treatment of status epilepticus: current thinking. Emerg Med Clin North Am 27:101-113, 2009.
