Recurrent Status Epilepticus in an Adult With Spastic Quadriplegic Cerebral Palsy

TL;DR

This paper discusses a case of a young adult with cerebral palsy who experienced a prolonged seizure emergency and highlights the challenges in managing such cases.

Contribution

The paper presents a unique case emphasizing the management challenges of status epilepticus in adults with cerebral palsy.

Findings

The patient's seizures ceased after treatment with intravenous diazepam and phenytoin.

Prompt diagnosis and treatment were crucial in managing the seizure emergency.

Multidisciplinary follow-up and caregiver education are essential for preventing recurrence.

Abstract

Status epilepticus (SE) is a neurological emergency associated with high morbidity and mortality. Management of individuals with cerebral palsy (CP) presents unique challenges due to baseline neurological deficits, limited communication, and altered metabolism of antiepileptic drugs (AEDs). We report the case of a 22-year-old male with spastic quadriplegic CP and long-standing epilepsy who presented with recurrent generalized tonic-clonic seizures persisting for five hours despite medication compliance. His pre-existing neurological impairment complicated early recognition. A non-contrast CT brain ruled out intracranial hemorrhage, stroke, and infection. The patient was treated with intravenous diazepam and phenytoin, resulting in seizure cessation within two hours, and was discharged seizure-free after four days. This report highlights the importance of prompt diagnosis and timely escalation of treatment in SE in adults with CP. Multidisciplinary follow-up and caregiver education remain essential for long-term control and prevention of recurrence.

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