who then are found to have no detectable
abnormality on post-mortem.

Management is therefore to provide oxygen and to abolish the inappropriate
muscular activity. Airway control by ET intubation and the accompanying
paralysis will abort the muscle activity.  Why then does tonic-clonic
seizure activity not also lead to sudden death? Well, in the community it
can do if unchecked. Most seizures are self-limiting, but status is
dangerous. The muscle activity is usually less in seizures than in
hyperexcitable states as well.

So I end this little paper (which I am publishing formally) with a
request. If any of the group get a patient with such a state please
measure the gases before (or maybe immediately after) intubation to see if
this is reproducible - a case report is less useful than a series!

Best wishes,


Rowley Cottingham

rowley@cix.co.uk