BMJ Best Practice Podcast Status epilepticus
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Jul 14, 2022 Explore the complexities of status epilepticus, from diagnosis challenges to management strategies. Learn about distinguishing convulsive from non-convulsive status epilepticus, the use of antidepressants in epilepsy patients, and the critical need for timely intervention to prevent adverse outcomes.
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Time-Based Definition Of Status Epilepticus
- Status epilepticus is a seizure that becomes self-sustaining and unlikely to stop on its own.
- For convulsive status the diagnostic threshold (T1) is ~5 minutes and irreversible injury (T2) around 30 minutes.
Non-Convulsive Status Has Later Timepoints
- Non-convulsive status epilepticus has later diagnostic and injury timepoints than convulsive status.
- T1 for non-convulsive is ~10–15 minutes and T2 (risk of neuronal injury) is about an hour or more.
Diagnose By History And Observation
- Use history and observation to diagnose convulsive status; look for motor activity lasting >5 minutes.
- Recognize that by the time paramedics or ED staff arrive, intervention is usually required.