[Update on status epilepticus in children. Definition, classification and treatment]

Claudia Riffo Allende1

  • 1Universidad Católica de Chile, Hospital Pediátrico Calvo Mackenna, Liga Chilena contra la Epilepsia, Santiago de Chile, Chile.

Medicina
|September 15, 2023
PubMed

Insights

Status epilepticus (SE) is a critical neurological emergency in children, defined by prolonged seizures. Prompt treatment initiation, guided by specific timeframes (t1), is crucial to prevent severe outcomes and reduce morbidity.

Area of Science:

  • Neurology
  • Pediatrics
  • Emergency Medicine

Context:

  • Status epilepticus (SE) is the most common neurological emergency in pediatric patients.
  • SE results from the failure of seizure-terminating mechanisms, leading to prolonged seizures.
  • Incidence ranges from 3-42 cases per 100,000 annually, with a bimodal distribution affecting children and the elderly.

Purpose:

  • To define status epilepticus (SE) with updated time-sensitive criteria (t1 and t2).
  • To emphasize the importance of timely treatment for pediatric SE.
  • To highlight the impact of SE on morbidity and mortality.

Summary:

  • SE is a prolonged epileptic seizure due to failed termination mechanisms.
  • Treatment should commence at specific times (t1): 5 minutes for generalized tonic-clonic seizures, 10 minutes for focal seizures.
  • Neuronal damage (t2) is a critical consideration.

Impact:

  • Prompt SE treatment reduces risks of cardiac/respiratory complications, ICU admission, and death.
  • High morbidity rates (up to 66%) underscore the need for effective interventions.
  • Understanding SE's time-dependent nature is vital for improved pediatric neurological care.

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