UMEM Educational Pearls

Category: Critical Care

Title: Seizures and the Critically Ill

Keywords: seizure, metabolic (PubMed Search)

Posted: 11/11/2008 by Mike Winters, MD (Updated: 10/22/2020)
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Seizures in the Critically Ill

  • Seizures are a common complication in medical and surgical patients commonly arising from coexisting conditions associated with critical illness
  • Most seizures in the critically ill are generalized convulsions rather than focal
  • The majority of seizures occur in patients without a pre-existing history of seizure disorder
  • Common causes of seizures in the critically ill include sepsis, cardiovascular disease, metabolic abnormalities, medications, and drug intoxication/withdrawal
  • Metabolic abnormalities account for 30 -35% of causes
  • The most common metabolic abnormalities include hyponatremia, hypocalcemia, hypophosphatemia, uremia, and hypoglycemia
  • Be sure to check these labs in ICU patients with a seizure

References

Mirski MA, Varelas PN. Seizures and status epilepticus in the critically ill. Crit Care Clin 2008;24:115-147.