Clinical features and complications of status epilepticus in children Author Angus Wilfong, MD Section Editor Douglas R Nordli, Jr, MD Deputy Editor April F Eichler, MD, MPH Disclosures: Angus Wilfong, MD Grant/Research/Clinical Trial Support: Novartis [epilepsy ( Everolimus)]; UCB [epilepsy (Bivaracetam)]; Pfizer [epilepsy (Pregabalin)]; Upsher-Smith [epilepsy (Midazolam)]; G-W Pharma [epilepsy (cannabidiol)]. Speaker's Bureau: Cyberonics [epilepsy (vagus nerve stimulation)]; Supernus [epilepsy (oxcarbazepine extended release)]. Consultant/Advisory Boards: Cyberonics [epilepsy (vagus nerve stimulation)]. Douglas R Nordli, Jr, MD Nothing to disclose. April F Eichler, MD, MPH Equity Ownership/Stock Options: Johnson & Johnson [Dementia (galantamine), Epilepsy (topiramate)]. Employment: Employee of UpToDate, Inc. Contributor disclosures are reviewed for conflicts of interest by the editorial group. When found, these are addressed by vetting through a multi-level review process, and through requirements for references to be provided to support the content. Appropriately referenced content is required of all authors and must conform to UpToDate standards of evidence. Conflict of interest policy All topics are up dated as new ev idence becomes av ailable and our peer review process is complete. Literature review current through: Sep 2014. | This topic last updated: Dec 13, 2013. INTRODUCTION — The most common medical neurologic emergency in childhood, status epilepticus (SE) is a serious and often life-threatening medical emergency. The definition, pathophysiology, classifi cation, 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" .) DEFINITION — The International Classification of Epileptic Seizures defines status epilepticus (SE) as a seizure that lasts for a sufficient length of time (30 minutes or longer in most studies) or is repeated frequently enough that the individual does not regain consciousness between seizures [1,2]. This definition is arbitrary, and other studies have suggested that the definition should include patients with seizures of s horter duration (eg, over 10 minutes) [3,4]. For the purpose of treatment decisions, this shorter time definition has merit. One study found that a convulsive seizure lasting more than five minutes has a high risk of lasting 30 minutes or more [5]. Also, treatment delay is associated with delayed treatment response [6,7]. However, the outcome is worse with more prolonged seizures, suggesting that the standard definition be retained for epidemiologic studies. In one study, for example, 226 cases of SE (91 children and 135 adults) were compared to 81 patients (31 children and 50 adults) wit h seizure episodes
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