Status epilepticus in pediatric patients - NYSORA

Explore NYSORA knowledge base for free:

Status epilepticus in pediatric patients

Learning objectives

  • Describe the overall mechanisms and etiology of status epilepticus in pediatric patients
  • Manage status epilepticus in pediatric patients

Definition & mechanisms


  • Acute
  • Chronic
    • Inheritance tendency
    • Low concentration of anti-epileptic drugs
    • Structural changes to the brain (trauma) or space occypying lesions (tumor, stroke)
    • Idiopathic

Signs and symptoms

Status epilepticus can present in several forms: 

  • Convulsive: unresponsiveness and tonic, clonic, or tonic-clonic movements of the extremities
  • Non-convulsive: prolonged seizure activity evidenced by epileptiform discharges on EEG, change in behavior or cognition in some patients
  • Electrographic: commonly used for comatose patients who show electrographic evidence of prolonged seizure activity


  • Based on history and clinical examination
  • Often present either actively convulsing or minimal time between clustered seizures


  • Seizure detection based on EEG and immediate treatment
  • In patients with a history of well-controlled epilepsy, avoid disruption of antiepileptic medication perioperatively


Status epilepticus, benzodiazepine, phenytoin, thiopental, midazolam, ICU, seizure, diazepam, lorazepam, phenobarbital, paraldehyde

Suggested reading

  • 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;16(1):48-61.
  • Betjemann JP, Lowenstein DH. Status epilepticus in adults. Lancet Neurol. 2015;14(6):615-624.
  • Perks A, Cheema S, Mohanraj R. Anaesthesia and epilepsy. BJA: British Journal of Anaesthesia. 2012;108(4):562-71.
  • Barakat, A.R., Mallory, S., 2011. Anaesthesia and childhood epilepsy. Continuing Education in Anaesthesia Critical Care & Pain 11, 93–98.

We would love to hear from you. If you should detect any errors, email us at