The causes of convulsive status epilepticus in adults

Elizabeth J. Waterhouse, Peter W. Kaplan

Research output: Chapter in Book/Report/Conference proceedingChapter

Abstract

Definition Convulsive status epilepticus (CSE) has been recognized for centuries and its definition continues to evolve. In 1981, the International League Against Epilepsy and the World Health Organization defined status epilepticus (SE) as occurring “Whenever a seizure persists for a sufficient length of time, or is repeated frequently enough to produce an enduring epileptic condition.” The imprecise duration described in this definition made its application in research difficult, and a definition published in 1993 proposed that SE consists of “more than 30 minutes of continuous seizure activity, or two or more sequential seizures without full recovery of consciousness between seizures” (Dodson et al.1993). The 30-min time designation was supported by animal studies and human data showing physiological deterioration occurring after about 30 min of seizure activity (Lothman 1990). While this definition has been widely used for research, an operational definition of CSE advocates administering intravenous treatment after only 5 min of seizure activity (Lowenstein et al. 1999). This definition is supported by a study that documented the duration of a generalized tonic–clonic (GTC) seizure to be about 1 min on average, and to rarely exceed 2 min (Theodore et al. 1994). Therefore, a seizure lasting more than several minutes is unlikely to be self-limited, and treatment is warranted for impending SE, in order to terminate ictal activity and reduce morbidity and mortality.

Original languageEnglish (US)
Title of host publicationThe Causes of Epilepsy
Subtitle of host publicationCommon and Uncommon Causes in Adults and Children
PublisherCambridge University Press
Pages735-744
Number of pages10
ISBN (Electronic)9780511921001
ISBN (Print)9780521114479
DOIs
StatePublished - Jan 1 2011

ASJC Scopus subject areas

  • Medicine(all)

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