Status epilepticus

Status epilepticus is a seizure that lasts ≥ 5 minutes or a series of seizures in rapid succession without full neurological recovery in the interictal period, which increases the risk of long-term consequences such as neuronal injury and functional deficits.

The time threshold after which a seizure is considered status epilepticus differs according to the type of seizure:

• Tonic-clonic seizures: ≥ 5 minutes

• Focal seizures with impaired consciousness: ≥ 10 minutes

• Absence seizures: 10–15 minutes

Withdrawal from antiepileptic drugs

Electrolyte imbalance (e.g., hyponatremia, hypocalcemia)

Metabolic disturbances (e.g., hypoglycemia, uremia, porphyria)

Structural brain lesions and/or injury (e.g., tumors, trauma, stroke)

Anoxic brain injury

Alcohol withdrawal

Recreational drug use

Drug toxicity (e.g., from tricyclic antidepressants, isoniazid)

CNS infections (e.g., cerebral malaria, neurocysticercosis, viral encephalitis, prion diseases)

Late-stage neurodegenerative diseases (e.g., Alzheimer disease)

With prominent motor features

• Convulsive (tonic-clonic)

• Myoclonic (with or without coma)

• Focal motor

• Tonic

• Hyperkinetic

Without prominent motor features: nonconvulsive status epilepticus (NCSE)

• With coma

• Without coma

  • Absence

  • Focal (e.g., aphasia, impaired consciousness, ongoing autonomic or sensory symptoms)

Mortality is bimodal, with the highest risk in neonates (25–39%) and patients > 80 years of age (> 50%). [73][74]

Overall infant and child mortality: 3.6% [75]

Overall adult mortality: 15.9%