Table of ContentsView AllTable of ContentsSymptomsCausesDiagnosisTreatment
Table of ContentsView All
View All
Table of Contents
Symptoms
Causes
Diagnosis
Treatment
Status epilepticusis a dangerous situation historically defined as aseizureor a cluster of seizures lasting longer than 30 minutes without improvement in consciousness. When seizures do not improve, on their own or with medication, they can cause brain damage or even death. Therefore, this 30-minute definition is not used in clinical practice; instead, any continuous seizure lasting five minutes or more, or two or more successive seizures without recovery of consciousness is considered status, requiring immediate treatment with anti-seizure medications. However, there are times when someone with status epilepticus may not improve despite treatment.
Verywell / Emily Roberts
In general, seizures tend to last from a few seconds to a few minutes, depending on the type of seizure. However, prolonged seizures can occur—and are always an emergency.
The symptoms of status epilepticus may be easy to recognize in some situations, but not others. Some cases of status epilepticus can be subtle, especially in people who are severely ill.
Symptoms of status epilepticus are generally the same as those for epilepsy. The differences lie in their duration and the fact that the seizures can happen repeatedly without the person regaining consciousness.
Symptoms of status epilepticus may include:
Serious SymptomsGet emergency medical help when:Seizure symptoms last for longer than five minutesSomeone loses consciousness and doesn’t wake upSomeone has repeated seizures without waking up in between
Serious Symptoms
Get emergency medical help when:Seizure symptoms last for longer than five minutesSomeone loses consciousness and doesn’t wake upSomeone has repeated seizures without waking up in between
Get emergency medical help when:
Some triggers and conditions make status epilepticus more likely, but sometimes it can occur without a known reason.
Possible triggers include:
Prevalence and Risk Factors
Status epilepticus occurs in 50,000 to 150,000 people in the United States each year. It’s more likely in children under 10, adults over 50, and those with febrile (fever-related) seizures.
Studiesnote that between 30 percent and 44 percent of status epilepticus cases are in people previously diagnosed with epilepsy. In children, nearly 70 percent of cases are in those with diagnosed epilepsy, and skipping medication was believed to be a major cause.
Research showsthat Black people are significantly more likely than those of other races to experience status epilepticus. Researchers suspect this is due, at least in part, to socioeconomic factors that may influence the ability to access treatment.
Death from status epilepticus is more common in men than in women, and it grows more common with age. Children under 10 have the best outcomes, with deaths in less than 3 percent of cases. That goes up to 30 percent for adults.
Diagnosing status epilepticus and identifying the cause is important because status epilepticus requires different treatment than the other conditions that have similar symptoms.
Status epilepticus is a medical emergency. It can cause death due to physical injury, choking, or as a result of the seizure itself. The episode may cause lasting brain damage, which can result in worsening seizures, increased predisposition to status epilepticus, and cognitive decline.
The American Epilepsy Society has made recommendations for the treatment of status epilepticus
First-line medications for status epilepticus include:
If the initial drug doesn’t work, emergency medical staff may use a second drug, such as:
These medications act quickly, and their effects do not typically last for longer than a few hours. They can cause worsening of symptoms for people who do not have epilepsy. For example, lorazepam can make encephalopathy worse.
Treatment approaches for related conditions may include:
A Word From Verywell
If you or your child has experienced status epilepticus, you’re well aware of how frightening it can be. It is important to recognize the symptoms that occur right before the seizure and to take medication to try to prevent it. Have a convenient method of calling for emergency medical help so that you can receive proper treatment as soon as possible. With the right treatment, seizures can be controlled, the episodes of status epilepticus can be reduced, and the triggering cause(s) can be addressed.
SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Dham BS, Hunter K, Rincon F.The epidemiology of status epilepticus in the United States.Neurocrit Care. 2014 Jun;20(3):476-83. doi: 10.1007/s12028-013-9935-x.Glauser T, Shinnar S, Gloss D et al.Evidence-Based Guideline: Treatment of Convulsive Status Epilepticus in Children and Adults: Report of the Guideline Committee of the American Epilepsy Society.Epilepsy Curr. 2016 Jan-Feb;16(1):48-61. doi: 10.5698/1535-7597-16.1.48.Lu WY, Weng WC, Wong LC, Lee WT.The etiology and prognosis of super-refractory convulsive status epilepticus in children.Epilepsy Behav. 2018 Jul 10. pii: S1525-5050(18)30390-1. doi: 10.1016/j.yebeh.2018.06.029.Lv RJ, Wang Q, Cui T, Zhu F, Shao XQ.Status epilepticus-related etiology, incidence and mortality: a meta-analysis.Epilepsy Res. 2017 Oct;136:12-17. doi: 10.1016/j.eplepsyres.2017.07.006.Neligan A, Shorvon SD.Frequency and prognosis of convulsive status epilepticus of different causes: a systematic review.Arch Neurol. 2010 Aug;67(8):931-40. doi: 10.1001/archneurol.2010.169.Sanchez S, Rincon F.Status epilepticus: epidemiology and public health needs.J Clin Med. 2016 Aug 16;5(8). pii: E71. doi: 10.3390/jcm5080071.
Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Dham BS, Hunter K, Rincon F.The epidemiology of status epilepticus in the United States.Neurocrit Care. 2014 Jun;20(3):476-83. doi: 10.1007/s12028-013-9935-x.Glauser T, Shinnar S, Gloss D et al.Evidence-Based Guideline: Treatment of Convulsive Status Epilepticus in Children and Adults: Report of the Guideline Committee of the American Epilepsy Society.Epilepsy Curr. 2016 Jan-Feb;16(1):48-61. doi: 10.5698/1535-7597-16.1.48.Lu WY, Weng WC, Wong LC, Lee WT.The etiology and prognosis of super-refractory convulsive status epilepticus in children.Epilepsy Behav. 2018 Jul 10. pii: S1525-5050(18)30390-1. doi: 10.1016/j.yebeh.2018.06.029.Lv RJ, Wang Q, Cui T, Zhu F, Shao XQ.Status epilepticus-related etiology, incidence and mortality: a meta-analysis.Epilepsy Res. 2017 Oct;136:12-17. doi: 10.1016/j.eplepsyres.2017.07.006.Neligan A, Shorvon SD.Frequency and prognosis of convulsive status epilepticus of different causes: a systematic review.Arch Neurol. 2010 Aug;67(8):931-40. doi: 10.1001/archneurol.2010.169.Sanchez S, Rincon F.Status epilepticus: epidemiology and public health needs.J Clin Med. 2016 Aug 16;5(8). pii: E71. doi: 10.3390/jcm5080071.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Dham BS, Hunter K, Rincon F.The epidemiology of status epilepticus in the United States.Neurocrit Care. 2014 Jun;20(3):476-83. doi: 10.1007/s12028-013-9935-x.Glauser T, Shinnar S, Gloss D et al.Evidence-Based Guideline: Treatment of Convulsive Status Epilepticus in Children and Adults: Report of the Guideline Committee of the American Epilepsy Society.Epilepsy Curr. 2016 Jan-Feb;16(1):48-61. doi: 10.5698/1535-7597-16.1.48.Lu WY, Weng WC, Wong LC, Lee WT.The etiology and prognosis of super-refractory convulsive status epilepticus in children.Epilepsy Behav. 2018 Jul 10. pii: S1525-5050(18)30390-1. doi: 10.1016/j.yebeh.2018.06.029.Lv RJ, Wang Q, Cui T, Zhu F, Shao XQ.Status epilepticus-related etiology, incidence and mortality: a meta-analysis.Epilepsy Res. 2017 Oct;136:12-17. doi: 10.1016/j.eplepsyres.2017.07.006.Neligan A, Shorvon SD.Frequency and prognosis of convulsive status epilepticus of different causes: a systematic review.Arch Neurol. 2010 Aug;67(8):931-40. doi: 10.1001/archneurol.2010.169.Sanchez S, Rincon F.Status epilepticus: epidemiology and public health needs.J Clin Med. 2016 Aug 16;5(8). pii: E71. doi: 10.3390/jcm5080071.
Dham BS, Hunter K, Rincon F.The epidemiology of status epilepticus in the United States.Neurocrit Care. 2014 Jun;20(3):476-83. doi: 10.1007/s12028-013-9935-x.
Glauser T, Shinnar S, Gloss D et al.Evidence-Based Guideline: Treatment of Convulsive Status Epilepticus in Children and Adults: Report of the Guideline Committee of the American Epilepsy Society.Epilepsy Curr. 2016 Jan-Feb;16(1):48-61. doi: 10.5698/1535-7597-16.1.48.
Lu WY, Weng WC, Wong LC, Lee WT.The etiology and prognosis of super-refractory convulsive status epilepticus in children.Epilepsy Behav. 2018 Jul 10. pii: S1525-5050(18)30390-1. doi: 10.1016/j.yebeh.2018.06.029.
Lv RJ, Wang Q, Cui T, Zhu F, Shao XQ.Status epilepticus-related etiology, incidence and mortality: a meta-analysis.Epilepsy Res. 2017 Oct;136:12-17. doi: 10.1016/j.eplepsyres.2017.07.006.
Neligan A, Shorvon SD.Frequency and prognosis of convulsive status epilepticus of different causes: a systematic review.Arch Neurol. 2010 Aug;67(8):931-40. doi: 10.1001/archneurol.2010.169.
Sanchez S, Rincon F.Status epilepticus: epidemiology and public health needs.J Clin Med. 2016 Aug 16;5(8). pii: E71. doi: 10.3390/jcm5080071.
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