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Novmber 8, 1976

Treatment of Status Epilepticus

Author Affiliations

Creedmoor Psychiatric Center Queens Village, NY

JAMA. 1976;236(19):2174. doi:10.1001/jama.1976.03270200013013

To the Editor.—  Dr Schneider, while conceding that anticonvulsant medication is effective in the treatment of hypoglycemic and hypocalcemic status epilepticus, advocates delay in administering anticonvulsant drugs (ACDs) pending determination of glucose and calcium blood levels. This view does not seem to take into account that status epilepticus is often a medical emergency that can be lethal. Moreover, there is no way of knowing how much additional brain damage can be inflicted by a prolonged, severe episode of status epilepticus.We agree it is necessary to obtain a blood sample, particularly to determine ACD-plasma levels. In dealing with a known epileptic in this state, the patient's plasma will often be found to contain little or no ADC. This is usually a result of noncompliance. If a patient is seen for the first time and is not known to be seizure-prone, it may be helpful to determine glucose and calcium levels,