[Status epilepticus in childhood]

Abstract

Status epilepticus (SE) is one of the most common emergencies in pediatric neurology and it is associated with high mortality and morbidity. SE is more frequent in children than in adults. SE occurs in variety of settings especially in children-infections, patients with previously established epilepsy, cerebral malformations, hypoxia, hypoglucemia and head trauma- but in many cases SE can present as a first unprovoked seizures. Being better known the convulsive SE, non-convulsive SE that may present the same complications as the convulsive SE may be found in many patients. The mortality associated with SE in children is between 3 and 7%. The mortality and morbidity is estimated very high in the refractory SE. Although SE is defined as more than 30 min of continuous seizure activity, antiepileptic drug administration should be considered whenever a seizure has lasted 10 min. Initial therapeutic and etiological diagnostic have be conducted simultaneously. The commonest lines for treating SE and SE refractory are shown. The SE treatment should be managed including the ABCs of vital functions-supporting respiration, maintaining blood pressure, gaining access to circulation, electrolyte levels, renal and hepatic functioning and glucose levels- as well as a prompt administration of appropriate drugs in adequate doses. The different antiepileptic drugs that can be administered to the SE treatment are presented as well as the pharmacologic peculiarities, route of choice for drug administration, doses and risks of the traditional and the new antiepileptic drugs.