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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.