RT Book, Section A1 Busl, Katharina M. A1 Bleck, Thomas P. A2 Hall, Jesse B. A2 Schmidt, Gregory A. A2 Kress, John P. SR Print(0) ID 1107722118 T1 Seizures in the Intensive Care Unit T2 Principles of Critical Care, 4e YR 2015 FD 2015 PB McGraw-Hill Education PP New York, NY SN 9780071738811 LK accesssurgery.mhmedical.com/content.aspx?aid=1107722118 RD 2024/03/28 AB Seizures are a relatively common occurrence in the intensive care unit (ICU), but may be difficult to recognize.Seizures that persist longer than 5 to 7 minutes should be treated to prevent progression to status epilepticus.Three major factors determine outcome in status epilepticus: type of seizure, cause, and duration.Electroencephalographic (EEG) monitoring to titrate therapy should be implemented in seizing patients who do not awaken promptly after institution of antiepileptics, even if tonic-clonic motor activity resolves.Lorazepam is a preferred agent for initial treatment, followed by consideration of additional agents for long-term management or to “break” status epilepticus.Patients with refractory status epilepticus require intubation, mechanical ventilation, and aggressive treatment with antiepileptics titrated to the EEG.The underlying cause of the seizure disorder must be sought in tandem with treatment of the seizure disorder itself.