Generalized convulsive status epilepticus (GCSE) is a type of status epilepticus (SE). It is a neurological seizure disorder that presents with seizures that last 30 minutes or longer and wherein consciousness is lost. GCSE is the most common and deadly type of status epilepticus.
Status epilepticus is a neurological condition. Electrical activity in the brain increases, which causes irregular neuron activity. This electrical activity is continual. When the increase in electrical activity leads to seizure activity and the seizure lasts for 30 minutes or longer with a loss of consciousness, the condition is classified as generalized convulsive status epilepticus.
There are several causes of status epilepticus. Many patients who are diagnosed with generalized convulsive status epilepticus have a history of epilepsy. Unsuccessful treatment of the epilepsy often leads to GCSE as electrical activity continues to increase. Patients who do not have epileptic history can suffer from GCSE as a result of traumatic injury to the brain, systemic infections, or neoplasms of the central nervous system.
Diagnosing generalized convulsive status epilepticus involves many methods of testing. Blood and urine samples are tested to monitor electrolyte levels, complete blood count, and the amounts of anti-convulsant medications in the body. An electroencephalography (EEG) is a test that measures the electrical activity of the brain and is the primary basis for diagnosis. EEG testing is particularly useful in determining the length of seizure activity when physical convulsing has stopped.
Although convulsive status epilepticus presents additional symptoms that help confirm a diagnosis, typical symptoms of SE include continuous seizure activity that lasts longer than 30 minutes or two or more seizures occurring back to back. Consciousness is lost and is not regained at the same level as before the activity began. GCSE may involve neuron death, tongue biting, and muscle stiffness over the whole body. These seizures are called generalized tonic-clonic seizures.
Damage to neurons is not the only type of damage that can occur if seizure activity continues to occur and remains prolonged. A continued convulsion reduces the amount of oxygen that is circulated through the body. This can cause tissue and cell death because oxygen is a basic necessity for the survival and function of the body.
Generalized convulsive status epilepticus requires immediate medical attention and treatment due to the amount of damage that can occur. Intravenous antiepileptic medications and sedatives are often used to stop convulsions and reduce the level of electrical activity in the brain. Oxygen assistance may also be provided if concentration levels are low. Long-term treatment for GCSE includes oral antiepileptic medications.