What is the main risk from a prolonged seizure?

The main risk from a prolonged seizure is hypotension, which can occur due to several physiological changes in the body during the seizure activity. During a seizure, the autonomic nervous system is activated, leading to increased heart rate and potential alterations in blood vessel tone. If the seizure lasts for an extended period, the body's normal regulatory mechanisms can become impaired, leading to significant drops in blood pressure.

While dehydration and infection can be concerns in patients with seizures, they are not immediate or direct risks associated with prolonged seizures. Dehydration may arise if the patient is unable to drink fluids during or after a seizure, and infection could occur as a secondary effect, particularly in cases where there is associated trauma or aspiration. However, the primary and immediate risk that arises directly from the occurrence of a prolonged seizure is hypotension, making it the most critical concern to address in emergency care.