STATUS EPILEPTICUS: A MEDICAL EMERGENCY

“Suppose the seizure lasts more than 30 minutes. Suppose the child has one seizure after another without waking up between them. What do I do then?”
Status epilepticus is a medical emergency! “STATUS EPILEPTICUS” IS DEFINED AS A SEIZURE THAT LASTS A LONG TIME. SOME PEOPLE DEFINE A LONG TIME AS TWENTY MINUTES, THIRTY minutes, or an hour. We would recommend not being too concerned about a tonic-clonic “grand mal” seizure that lasts fewer than ten to fifteen or twenty minutes. There is no evidence that even thirty minutes of generalized tonic-clonic movement does damage to the brain. Even an hour of tonic-clonic seizures is unlikely to do damage to the brain, but we would not recommend purposely allowing a seizure to continue that long.
There are actually two types of status. One is the status epilepticus that most people think about, convulsive status, in which the patient is having tonic-clonic, shaking seizures for this long period of time. A separate type, nonconvulsive status, is an episode when a patient has absence spells, staring spells, or periods of confusion lasting a half-hour, an hour, or (rarely) days. This nonconvulsive status is not life-threatening or brain-damaging, but should be recognized.
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