Acute Medicine | Palliative care | Management of seizures

Management of seizures
Session overview
Description
Acute seizure activity (also commonly known as convulsions) is one of the few situations considered a medical emergency for end of life care patients. It requires urgent intervention. This session provides a framework for the immediate management and longer term treatment of acute seizures.

This session was reviewed by Sarah Hanrott and last updated in August 2024.

Learning objectives
By the end of this session you will be able to:

• provide a working definition of acute seizures
• list the likely causes of seizures in an end of life care population
• describe the signs and symptoms associated with seizures
• explain the immediate management of acute seizures
• outline the longer term management of patients with seizures

If you complete the advanced section of this session you will be able to:

• discuss the management of prolonged intractable seizures (status epilepticus) as a periterminal event

The detection and management of acute seizures is one of the few situations in end of life care that is considered a medical emergency. This is because immediate diagnosis and treatment can minimise risk of neurological damage, and also because witnessing seizures can be a frightening and distressing experience for family/carers.

There are several possible causes of seizures but in our patient population the most common reason is secondary to cancer.

This session discusses the main predisposing factors and provides a general framework for immediate management of seizures. With an end-of-life care population however, management must be tailored to the individual’s disease state and condition. This session also addresses those rare occasions in advanced disease, when seizures are a periterminal event, and management may be aimed entirely at minimising distress for the patient and carers.