How is status epilepticus (SE) defined?

Updated: Feb 13, 2018
  • Author: Julie L Roth, MD; Chief Editor: Stephen A Berman, MD, PhD, MBA  more...
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Answer

In early studies, SE was defined by its duration—that is, as continuous seizures occurring for longer than 1 hour. Clinical and animal experiences later showed that pathologic changes and prognostic implications occurred when SE persisted for 30 minutes. Therefore, the time for the definition was shortened.

The working group on SE of the Epilepsy Foundation (formerly the Epilepsy Foundation of America) formulated the current definition: "More than 30 minutes of continuous seizure activity or two or more sequential seizures without full recovery of consciousness between seizures." [14]

Many believe that a shorter period of seizure activity causes neuronal injury and that seizure self-termination is unlikely after 5 minutes. [15] Consequently, Lowenstein and others have suggested a duration of longer than 5 minutes as part of the a criterion for SE, if the seizure type is one in which typical generalized convulsive seizures resolve spontaneously after 3-5 minutes. [16] The Epilepsy Foundation working group recommended that emergency department physicians treat seizures as SE if seizure activity has continued for more than 10 minutes. [14]


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