The moment a seizure starts, you have one job: keep the patient safe and make the next decision fast. We sit down with epileptologist Dr. Johnson to turn seizure care into clear bedside actions, starting with how seizure classification has evolved from vague labels to practical terms like focal aware, focal impaired awareness, and generalized seizure types that actually help teams communicate.

From there, we walk through an emergency-ready approach to tonic clonic seizures and status epilepticus: airway and positioning, what not to do, when the three-minute mark should change your plan, and how IV lorazepam or IM midazolam fits into first-line rescue. We also cover what comes immediately after the benzo, including loading longer-acting anti-seizure medications like levetiracetam, valproic acid, and phenytoin derivatives, plus what to look for when you’re asking why the seizure happened at all. You’ll hear practical guidance on glucose, labs, imaging, when lumbar puncture belongs on the table, and when EEG helps confirm whether a patient is truly back to baseline.

We then step into high-stakes territory with refractory status epilepticus, where intubation, IV anesthetic drips, and rapid EEG become essential because the bedside exam disappears. Finally, we bring it home with real-world outpatient tools like intranasal rescue benzodiazepines for seizure clusters, and we review long-term epilepsy medications, including why newer drugs often mean better tolerability and fewer interactions and why cenobamate is a standout for medication-resistant focal epilepsy. If you found this helpful, subscribe, share the show with a colleague, and leave a review with your biggest seizure-care question for us to tackle next.

Transcript https://www.buzzsprout.com/2522203/18830040-episode-3-updates-in-epilepsy-care/transcript

A patient’s symptoms have resolved… so why does it still matter? In this episode, we dive into Transient Ischemic Attacks (TIAs) with Dr Lee Chung. We unpack why these “warning strokes” demand immediate attention. We’ll cover classic and subtle symptoms, the mechanisms behind TIAs, and how modern treatment strategies aim to prevent a devastating stroke before it happens. Whether you’re in the ED, EMS, inpatient care, or outpatient follow-up, this episode reinforces why time, teamwork, and timely decision-making are essential in TIA care.

In this episode, we sit down with Dr. Brian Johnson from the University of Utah to explore non-epileptic seizures (NES)—what they are, how to recognize them, and the best approaches for treatment and patient support. We discuss common misconceptions, bedside assessment strategies, and the importance of collaboration between neurology and behavioral health teams.

Tune in to gain practical insights you can apply in clinical practice and improve care for patients experiencing seizure-like episodes.

Resources:

https://neurosymptoms.org/en/

https://www.epilepsy.com/

https://psychiatryonline.org/doi/pdf/10.1176/appi.neuropsych.19120354?download=true&utm_source=chatgpt.com