Repeated epileptic fits (see EPILEPSY) with no or only brief return to consciousness between them. Minor epileptic status (‘petit mal status’) looks less dramatic in that the abnormal movements may be localised to one or other limb and may appear as twitching rather than a full-blown seizure. Analysis by continuous recording of ELECTROENCEPHALOGRAPHY (EEG) has also shown that it is possible to have status epilepticus with little outward sign beyond confusion and minor involuntary movements. Epileptic status can be dangerous; the brain becomes starved of oxygen and glucose, so urgent medical attention is required to control the condition, or the patient may suffer permanent brain damage. Immediate first aid by a doctor or paramedic involves rectal or intravenous administration of a rapidly acting anti-epileptic drug (such as diazepam), the provision of oxygen and transfer to hospital. In-patient treatment involves following a protocol for giving sequential anti-epileptic drugs; ultimately it might be necessary to anaesthetise and paralyse the patient whilst providing ARTIFICIAL VENTILATION OF THE LUNGS until seizure activity ceases.