Pediatric Status Epilepticus: Initial Management and the Special Syndromes of Status Epilepticus in Children

Abstract

Status epilepticus (SE) requires prompt recognition and emergency treatment to reduce morbidity and mortality. SE results from a primary central nervous system (CNS) insult, or a systemic disorder with secondary CNS effects. SE is defined by seizure duration and semiology: either SE with prominent motor symptoms [convulsive SE (CSE)] or SE without prominent motor symptoms [nonconvulsive SE (NCSE)]. It is important to treat the precipitating cause in order to control SE, with symptomatic SE more common in younger children and infants. Evidence-based guidelines for the diagnostic assessment of SE in children and SE treatment guidelines are available. This chapter reviews the new definition and classification of SE from the International League Against Epilepsy, the initial presentation and management of SE, including acute repetitive seizures (ARS), the diagnostic evaluation, revised definition of refractory SE, pre-hospital treatment, and the unique syndromes of SE in children and their treatment.