Status Epilepticus and Acute Repetitive Seizures in Children, Adolescents, and Young Adults: Etiology, Outcome, and Treatment

  title={Status Epilepticus and Acute Repetitive Seizures in Children, Adolescents, and Young Adults: Etiology, Outcome, and Treatment},
  author={Wendy G. Mitchell},
  • W. Mitchell
  • Published 1 February 1996
  • Medicine, Psychology
  • Epilepsia
Summary: Status epilepticus (SE) is one of the most common neurologic emergencies in children, adolescents, and young adults. SE may be due to acute neurologic conditions such as meningitis, encephalitis, or stroke, complicated febrile seizures, intractable epilepsy, degenerative diseases, intoxication, or may be the first manifestation of epilepsy. Initial treatment of convulsive SE is usually with an intravenous benzodiazepine (BZD) [lorazepam (LZP) or diazepam (DZP)], phenobarbital (PB), or… 

Acute Seizures and Status Epilepticus

Management of Acute Repetitive Seizures

Diazepam rectal gel, a newer formulation of diazepam intended for rectal administration, effectively terminates acute seizures and prevents recurrence within the first 12 hours after administration.

Benzodiazepines for prolonged seizures

  • Mark S. Anderson
  • Biology, Medicine
    Archives of Disease in Childhood: Education & Practice Edition
  • 2010
Diazepam, lorazepam and midazolam, the drugs most widely used to stop prolonged seizures, are members of the benzodiazepine family, a class of psychoactive drugs with varying hypnotic, sedative, anxiolytic, anticonvulsant, muscle relaxant and amnesic properties.

Refractory Convulsive Status Epilepticus in Children: Etiology, Associated Risk Factors and Outcome

Theiology of SE significantly influenced prognosis of it with significant incidence of RSE in acute symptomatic group, and Mortality and morbidity rates were significantly higher in children with RSE than in those with SE.

Additional Modalities for Treating Acute Seizures in Children: Overview

  • E. Bebin
  • Medicine, Psychology
    Journal of child neurology
  • 1998
Treatment should be initiated early in patients who are prone to seizure clusters or prolonged partial seizures that may generalize or progress to status epilepticus, and the recently approved intravenous formulation of valproate may be of use in children receiving oralvalproate who develop breakthrough seizures caused by subtherapeutic plasma levels that are secondary to missed doses or an inability to tolerate oral valproates.

Management of Acute Seizure Episodes

Clinical trial data indicate that rectal administration of a prepackaged viscous DZP solution reduces seizure frequency and recurrence compared to seizure control, improved patient and family quality of life, and was cost‐effective because it reduced the need for emergency and inpatient treatment.

Acute seizure management in children

Randomized clinical trials demonstrate that benzodiazepines are still the cornerstones of the acute management of seizures, but treatment is still evolving owing to the approval of newer medications.

Seizures & Status Epilepticus

Most seizures that occur in the ICU setting manifest as generalized tonic-clonic convulsions, and Hypoglycemia should always be excluded.

Intravenous levetiracetam in Thai children and adolescents with status epilepticus and acute repetitive seizures.




Nonconvulsive Status Epilepticus in Adults and Children

Nonconvulsive status epilepticus (SE) accounts for approximately one‐quarter of all cases of SE and treatment includes antiepileptic drug(s) (AEDs) and avoidance of seizure precipitants.

Recurrent status epilepticus in children

Recurrent status epilepticus occurs primarily in children with an underlying neurological abnormality, and reoccurs in this group despite conventional antiepileptic drug therapy.

Admissions to a pediatric intensive care unit for status epilepticus: A 10‐year experience

Most cases of status epilepticus were caused by epilepsy, atypical febrile seizure, encephalitis, meningitis, or metabolic disease, and the prognosis was good in most surviving cases, more so if the neurologic development of the child was normal before the status epileptus.

Low morbidity and mortality of status epilepticus in children.

The mortality and incidence of sequelae following status epilepticus was low and primarily a function of etiology, and age did not affect outcome within each cause.

Lorazepam in childhood status epilepticus and serial seizures

LOR is a safe and effective acute anticonvulsant agent for in-hospital control of SE in the pediatric age group and in patients requiring sequential doses, LOR becomes progressively less effective.

Neurosurgical Treatment of Refractory Status Epilepticus

Operative treatment should be considered in patients with RSE in whom a focus of seizure onset can be demonstrated and who are reasonably considered surgical candidates.

Effects of long barbiturate anaesthesia on eight children with severe epilepsy.

Positive results were more often achieved when the treatment lag was less than 12 months, and good effect seemed to be associated with an anaesthesia which is deep and long enough to produce loss of consciousness and spontaneous reactions, and an electroencephalographic pattern of burst-suppression.

Status epilepticus at an urban public hospital in the 1980s

The clinical course of adult patients treated for generalized status epilepticus at the San Francisco General Hospital from 1980 to 1989 is reviewed to determine whether the etiologies of SE have changed over the last two decades, and to investigate the relationships between etiology, response to anticonvulsant therapy, and short-term clinical outcome.

Status Epilepticus Related to Alcohol Abuse

The results indicate that alcohol abuse is a common cause of SE and that SE may be the first presentation of alcohol‐related seizures, and the outcome of patients with alcohol-related SE compares favorably with that of patientswith SE due to other causes, but recovery of these patients may be complicated by a prolonged postictal state.