From the onset of status epilepticus, seizure activity greatly increases cerebral metabolism. Physiological mechanisms are initially sufficient largely to compensate for this perturbation. Cerebral blood flow is increased, and initially the delivery of glucose to the active cerebral tissue is maintained. Later systemic and cerebral lactate levels rise, and a profound lactic acidosis may develop.16 There are massive cardiovascular and autonomic changes. Blood pressure rises, as does cardiac output and rate. The autonomic changes result in sweating, hyperpyrexia, bronchial secretion, salivation, vomiting, and epinephrine (adrenaline) and noradrenaline release. Endocrine and autonomic changes also cause an early rise in sugar levels.

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