Watch this video to find out what status epilepticus is and what to expect when a loved one is going through it. Thank you to Sage Therapeutics for their support of this project.
What Is Status Epilepticus?
Status epilepticus occurs when a seizure lasts more than 5 minutes or when seizures occur very close together and the person doesn't recover consciousness between them. Just like there are different types of seizures, there are also different types of status epilepticus.
Over the last several decades, the length of a seizure that is considered as status epilepticus has shortened. It is now defined as any seizure lasting more than 5 minutes.
Very long seizures (those lasting 30 minutes or longer) are dangerous and even increase the risk of death. Therefore, it is important to recognize status epilepticus, so it can be treated before the risk of harm increases.
Learn More:Responding to Seizure Emergencies
Convulsive Status Epilepticus
This term describes the more common form of emergency that can occur with prolonged tonic-clonic (also called convulsive or grand mal) seizures lasting longer than 5 minutes. It is also used for repeated tonic-clonic seizures without recovery of consciousness in between and lasting 5 minutes or longer. People with short tonic-clonic seizures that only last a couple of minutes often may remain unresponsive for several minutes because of the seizure’s post-ictal state. This means that while the shaking has stopped, they are very sleepy and difficult to rouse during the period that follows the seizure. This is because brain function is still recovering. Most patients gradually regain consciousness within 15 to 20 minutes. This post-ictal period can make it hard to tell when a seizure begins and ends.
Convulsive status epilepticus occurs when:
- The active part (rhythmic shaking) of a tonic-clonic seizure lasts 5 minutes or longer
- A person goes into a repeated tonic-clonic seizures without recovering consciousness for a period of longer than 5 minutes
This type of status epilepticus is a medical emergency and requires treatment by a medical team in a hospital setting. This situation can be life-threatening and getting treatment started fast is vital. The outlook may vary depending on the cause of the seizure and if other medical problems or complications occur.
Nonconvulsive Status Epilepticus
This term is used to describe a single or repeated absence or focal impaired awareness seizures during which the person is not able to respond but is not displaying any movement or shaking of the body for longer than 10 minutes. This can begin as convulsive and then become nonconvulsive because of persistent seizures.
Nonconvulsive status epilepticus occurs when:
- The person is not aware of what is going on and is not able to respond.
- The seizure lasts longer than 10 minutes. These are unlikely to stop on their own and need emergency attention.
When this type of status epilepticus occurs or is suspected, emergency medical treatment in a hospital setting is needed. EEG testing is typically needed to confirm the diagnosis. At this point, treatment should be started immediately.
Treatment for status epilepticus is as follows:
- Rescue medications are used to stop the seizures.
- Oxygen and other breathing support, as well as IV fluids can be given.
- If repeated seizures cannot be stopped with anti-seizure medications or other treatments, hospital staff may decide to put a person into a coma to stop the seizures.
- Continuous EEG monitoring is needed to watch seizure activity and how a person responds to treatment.
Different tests are also needed to find the cause of the seizure emergency so it can be treated correctly. People with a known cause, such as a brain infection, brain tumor, or stroke, may have a worse outlook than those with no other medical problems or known cause.
Learn More:New-Onset Refractory Status Epilepticus (NORSE)
Ways to Reduce Seizure Emergencies
Taking Medication as Prescribed
Missing doses of seizure medicine is the most common cause of breakthrough seizures. Missed medicines can trigger seizures in people with both well-controlled and drug-resistant epilepsy. Seizures can happen more often than normal, be more intense, or develop into long seizures.
Know Your Seizure Triggers
Some people may find that their seizures occur in a pattern or are more likely to happen in certain situations. Keeping track of any triggers that may come before a seizure can help you recognize when a seizure may be coming. You can then be prepared and learn how to lessen the chance that a seizure may occur at this time.
Staying Safe with Rescue Therapies
People with seizures or epilepsy at risk for status epilepticus should speak to their doctor about emergency treatments. Rescue therapies are “as needed” medications that are only given during specific situations. The goal of a rescue therapy is to stop seizures quickly to prevent a seizure emergency, like status epilepticus.
The ideal rescue therapy is easy to use, fast acting, and has few side effects. It should also work well for your type of seizures. If you think you may benefit from having a rescue therapy on hand for emergency use, contact your healthcare provider.
Learn More:Reduce Risk with a Custom Seizure Action Plan
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