Status Epilepticus

What Is It?

Status epilepticus (SE) is a prolonged seizure or multiple seizures which occur back-to-back without rest between them. While most seizures last seconds or minutes, status can be continuous for even hours or days. The traditional definition of status defines it as continuous seizure activity lasting more than 30 minutes. However, many argue that seizures lasting even 5 to 10 minutes without signs of resolution should be treated as SE, especially if treatment for the seizure has been initiated without a response.

Status is considered a medical emergency. Ongoing seizures can cause damage to the cells of the brain leading to permanent disability or death. The longer a seizure goes on, the more damage that occurs. Therefore, when it becomes clear that a patient is in status, it is considered an emergency to treat and try to break the chain of seizures.

While SE can occur in patients with pre-existing epilepsy (especially with anti-seizure medication changes), it can occur for a number of different reasons, including trauma, cerebrovascular disease, intoxications, tumors, and others. In children, fever and febrile seizures are a common cause of status epilepticus. Status can occur with various types of seizures, but convulsive status, with motor convulsions, is the most dangerous with great potential for permanent damage to the brain.

How Is it Treated?

As stated above, when it becomes apparent that an individual is having an ongoing seizure without signs of stopping, it is considered a medical emergency to treat. In the hospital, treatment generally involves intravenous administration of various anti-seizure medications (such as midazolam, lorazepam, diazepam, phenytoin and/or phenobarbital). In patients known to be prone to seizures and with a history of status, rectal diazepam may be prescribed to be used at home or elsewhere outside of the hospital.

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Important Note: This site is not intended to offer medical advice. Every patient is different, and only your personal physician can help to counsel you about what is best for your situation. What we offer is general reference information about various disorders and treatments for your education.

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