Autonomic status epilepticus

This is a form of SE which occurs typically in Panyiotopoulos syndrome. The exact prevalence of this syndrome is unclear, and estimates have ranged from 0 to 6% of all children with epilepsy. The seizures consist of episodes of nausea, retching and vomiting, and deviation of the eyes. There may or may not be altered awareness. Other autonomic features occur including incontinence of urine, pallor, hyperventilation and headache. The EEG shows occipital spiking or runs of 3 Hz spike-wave and there is also often evidence of photosensitivity. About half of the seizure last longer than 30 minutes and so are categorized as 'status epilepticus'. The prognosis of the syndrome is excellent and at least 50% of patients have only a single attack, and most require no treatment. If treatment is required, any of the conventional first-line antiepileptic drugs can be used in monotherapy.

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