Clinical features and complications of status epilepticus in children
- Angus Wilfong, MD
Angus Wilfong, MD
- Chief of Neurology
- Barrow Neurologic Institute at Phoenix Children's Hospital
The most common medical neurologic emergency in childhood, status epilepticus (SE) is a serious and often life-threatening medical emergency.
The definition, pathophysiology, classification, risk factors, and outcome of status epilepticus in children are reviewed here. Treatment of this disorder is discussed separately. (See "Management of convulsive status epilepticus in children".)
The duration of continuous seizure activity used to define status epilepticus (SE) has varied over time. Historically, the International League Against Epilepsy (ILAE) and others defined SE as a single epileptic seizure of >30 minutes duration or a series of epileptic seizures during which function is not regained between ictal events in a 30 minute period . For the purposes of treatment decisions; however, a shorter time window (eg, >5 to 10 minutes of continuous seizures) has been favored and generally accepted in the clinical community, particularly for generalized convulsive seizures.
The ILAE revised its definition of SE in 2015, and the revised definition incorporates both of these time points . Specifically, SE is defined by the ILAE as:
●A condition resulting from either the failure of the mechanisms responsible for seizure termination or from the initiation of mechanisms which lead to abnormally prolonged seizures (after time point t1); and
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- Electrical (subclinical) seizures
- Neuronal loss
- - MR imaging
- - Neuron-specific enolase
- EPIDEMIOLOGY AND ETIOLOGY
- Risk factors
- Genetic factors
- SYSTEMIC COMPLICATIONS
- Glucose alterations
- Blood pressure disturbances
- Increased intracranial pressure
- Other findings
- - Recurrent seizures
- - Neurologic sequelae
- Refractory status epilepticus
- SUMMARY AND RECOMMENDATIONS