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Review
. 2014 Dec;26(6):668-74.
doi: 10.1097/MOP.0000000000000154.

Pediatric status epilepticus management

Nicholas S Abend  1 , Tobias Loddenkemper
Affiliations
Review

Pediatric status epilepticus management

Nicholas S Abend et al. Curr Opin Pediatr. 2014 Dec.

Abstract

Purpose of review: This review discusses the management of status epilepticus in children, including both anticonvulsant medications and overall management approaches.

Recent findings: Rapid management of status epilepticus is associated with a greater likelihood of seizure termination and better outcomes, yet data indicate that there are often management delays. This review discusses an overall management approach aiming to simultaneously identify and manage underlying precipitant causes, administer anticonvulsants in rapid succession until seizures have terminated, and identify and manage systemic complications. An example management pathway is provided.

Summary: Status epilepticus is a common neurologic emergency in children and requires rapid intervention. Having a predetermined status epilepticus management pathway can expedite management.

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Conflict of interest statement

Conflicts of Interest:

Dr. Abend has given expert testimony in medico-legal cases and receives royalties from Demos Medical Publishing for Pediatric Neurocritical Care.

Dr. Loddenkemper serves on the Laboratory Accreditation Board for Long Term (Epilepsy and Intensive Care Unit) Monitoring, on the Council of the American Clinical Neurophysiology Society, on the American Board of Clinical Neurophysiology, as an Associate Editor for Seizure, and performs video electroencephalogram long-term monitoring, electroencephalograms, and other electrophysiological studies at Boston Children’s Hospital and bills for these procedures.

Figures

Figure 1
Figure 1
Example status epilepticus evaluation and management pathway.
See this image and copyright information in PMC

References

    1. Chin RF, Neville BG, Peckham C, et al. Incidence, cause, and short-term outcome of convulsive status epilepticus in childhood: prospective population-based study. Lancet. 2006;368(9531):222–9. - PubMed
    1. Commission on Epidemiology and Prognosis, International League Against Epilepsy: Guidelines for epidemiologic studies on epilepsy. Epilepsia. 1993;34(4):592–596. - PubMed
    1. Shinnar S, Berg AT, Moshe SL, et al. How long do new-onset seizures in children last? Ann Neurol. 2001;49(5):659–64. - PubMed
    1. Brophy GM, Bell R, Claassen J, et al. Guidelines for the evaluation and management of status epilepticus. Neurocrit Care. 2012;17(1):3–23. This guideline from the Neurocritical Care Society provides direction regarding evaluation and management of children and adults with status epilepticus. - PubMed
    1. Riviello JJ., Jr Seizures in the context of acute illness. Curr Opin Pediatr. 2009;21(6):731–736. - PubMed

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