A 44-year-old man with alcohol use disorder presents with 8 minutes of continuous generalized convulsions without consciousness recovery. Vitals: BP 148/92, HR 118, RR 22, SpO2 88%, Temp 37.2°C. Point-of-care glucose 105 mg/dL. Serum magnesium 1.2 mg/dL (low). No recent head trauma reported. He requires immediate airway management and seizure cessation. Which of the following is the best next step in management?

  1. A)Observation only because most seizures are self limited
  2. B)Psychogenic nonepileptic seizure
  3. C)Diazepam followed by fosphenytoin for status epilepticusGABARITO
  4. D)Ethosuximide blocks thalamic T type calcium channels
  5. E)Carbamazepine use for focal seizures

Explicação

Convulsive status epilepticus requires immediate termination with a benzodiazepine, followed by a longer acting antiepileptic such as fosphenytoin to prevent recurrence. Ongoing generalized seizure activity beyond 5 minutes is unlikely to stop spontaneously an... Ver explicação completa e trilha adaptativa →

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