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Status Epilepticus, Pediatric

Rajesh K. Daftary, MD, MPH and Adam L. Numis, MD Reviewed 10/2018
 


BASICS

DESCRIPTION

  • Status epilepticus (SE) is defined as a continuous seizure lasting >30 minutes or recurrent seizures without return to baseline in between. After 30 minutes, ischemic injury to th...

DIAGNOSIS

HISTORY

  • Ask about onset of seizure activity, duration, characteristic movements, and similarity to prior episodes. Ask about prior need for anticonvulsants and intubation/coma induction.

  • Ask a...

TREATMENT

  • ABCs (stabilization of airway, supporting respiration, maintaining BP, and gaining intravascular access)

  • Assess for hypoxia, hemodynamics, hyperthermia, hypoglycemia, hyponatremia.

  • BP, EKG, an...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Patient Monitoring

  • Cardiorespiratory monitoring, level of care as appropriate for clinical status

  • Monitor hydration and creatine kinase (CK) levels in case of convu...

ADDITIONAL READING

  • Abend NS, Loddenkemper T. Pediatric status epilepticus management. Curr Opin Pediatr.  2014;26(6):668–674. [View Abstract on OvidInsights]

  • Appleton R, Macleod S, Martland T. Dru...

CODES

ICD9

  • 345.3 Grand mal status

  • 345.10 Generalized convulsive epilepsy, without mention of intractable epilepsy

  • 345.00 Generalized nonconvulsive epilepsy, without mention of intractable epilepsy

  • 345.80 ...

FAQ

  • Q: Does SE cause brain injury?

  • A: Neuronal loss may occur with prolonged SE after 30 minutes. This illness represents a neurologic emergency. Other determinants of outcome are hypoxic brain injury ...

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