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The Commission on Classiﬁcation and Terminology of the International League Against Epilepsy (ILAE) deﬁnes Status Epilepticus as:
“a seizure that persists for a suﬃcient length of time or is repeated frequently enough that recovery between attacks does not occur” (1).
There is no clear definition on the time period which a convulsion has to last before being classified as status epilepticus (SE) (2)
- originally, the ILEA defined SE as 30 minutes of sustained seizure activity or 2 or more seizures during this time period without a return to the baseline level of consciousness between seizures (2)
- animal data have indicated that more than 30 minutes of continuous seizure activity may result in permanent neuronal injury and pharmacoresistance (3)
- Lowenstein and colleagues have proposed a definition of SE based on seizures which are longer than 5 minutes or two or more discrete seizures without a return of consciousness between seizures (4)
Status epilepticus is a medical emergency because of the 20% mortality and
the high rates of neurological and systemic morbidity. Prolonged generalized
SE can lead to death or permanent brain damage (5).
Prolonged or repeated seizures and convulsive status epilepticus
- buccal midazolam or rectal diazepam should only be prescribed for use in
the community for children, young people and adults who have had a previous
episode of prolonged or serial convulsive seizures
- administer buccal midazolam as first-line treatment in children, young people
and adults with prolonged or repeated seizures in the community
- administer rectal diazepam if preferred or if buccal midazolam is not
- if intravenous access is already established and resuscitation facilities
are available, administer intravenous lorazepam
Last edited 09/2018