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Status Epilepticus in Children

  • Chapter
Status Epilepticus

Part of the book series: Current Clinical Neurology ((CCNEU))

Abstract

Status epilepticus (SE) is a life-threatening medical emergency that requires prompt recognition and treatment. SE is not a specific disease but is a manifestation of either a primary central nervous system (CNS) insult, or a systemic disorder with secondary CNS effects. It is mandatory to look for an underlying cause, especially in younger children and infants, in whom symptomatic SE is more common. Identifying and treating the precipitating cause helps control seizures, prevents ongoing neurologic injury, and hopefully prevents seizure recurrence. Basic neuroresuscitation principles, the ABCs (airway, breathing, circulation), are the cornerstone of initial treatment. An organized and systematic treatment regimen, planned in advance, is needed, including one for refractory status epilepticus (RSE). Initial treatment follows the ABCs but, once stabilized, patient management may be individualized.

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References

  1. Riviello JJ. Status epilepticus. In: Wyllie E, ed. The Treatment of Epilepsy: Principles and Practice 4th ed. Baltimore: Williams & Wilkins; (in press).

    Google Scholar 

  2. Gastaut H. Classification of status epilepicus. Adv Neurol 1983;34:15–35.

    PubMed  CAS  Google Scholar 

  3. Aicardi J, Chevrie JJ. Convulsive status epilepticus in infants and children: a study of 239 cases. Epilepsia 1970;11:187–197.

    PubMed  CAS  Google Scholar 

  4. Working Group on Status Epilepticus, Epilepsy Foundation of America. Treatment of convulsive status epilepticus. JAMA 1993;270:854–859.

    Article  Google Scholar 

  5. Proposal for revised classification of epilepsies and epileptic syndromes. Epilepsia 1989;30:389–399.

    Google Scholar 

  6. Treiman DM, Delgado-Escueda AV. Status epilepticus. In: Thompson RA, Green RA, Green JR, eds. Critical Care of Neurological and Neurosurgical Emergenices. New York: Raven Press; 1980;53–99.

    Google Scholar 

  7. Sahin M, Menache C, Holmes GL, Riviello JJ. Outcome of severe refractory status epilepticus in children. Epilepsia 2001;42:1461–1467.

    Article  PubMed  CAS  Google Scholar 

  8. Treiman DM, DeGiorgio CM, Salisbury S, Wickboldt C. Subtle generalized convulsive status epilepticus. Epilepsia 1984;25:653 (abstract).

    Google Scholar 

  9. Pakalnis A, Paolicchi J, Gilles E. Psychogenic status epilepticus in children: psychiatric and other risk factors. Neurology 2000;54:969–970.

    PubMed  CAS  Google Scholar 

  10. Tuxhorn IEB, Fischbach HS. Pseudostatus epilepticus in childhood Pediatr Neurol 2002;27:407–409.

    Article  PubMed  Google Scholar 

  11. Shorvon S. Status Epilepticus: Its Clinical Features and Treatment in Children and Adults. Cambridge: Cambridge University Press; 1994.

    Google Scholar 

  12. Riviello JJ. Pediatric status epilepticus. Ann Em Med (in press).

    Google Scholar 

  13. Treiman DM, Walton NY, Kendrick C. A progressive sequence of electroencephalographic changes during generalized convulsive status epilepticus. Epilepsy Res 1990;5:49–60.

    Article  PubMed  CAS  Google Scholar 

  14. Lowenstein DH, Aminoff MJ. Clinical and EEG features of status epilepticus in comatose patients. Neurology 1992;42:100–104.

    PubMed  CAS  Google Scholar 

  15. Garzon E, Fernandes RM, Sakamoto AC. Serial EEG during human status epilepticus: evidence for PLED as an ictal pattern. Neurology 2001;57:1175–1183.

    PubMed  CAS  Google Scholar 

  16. Morton LD, Leszczyszyn DJ, Kopec-Garnett L, Towne AR, Waterhouse EJ, Pellock JM, DeLorenzo RJ. Maturational changes in the EEG of status epilepticus in the first six months of life. Neurology 2000;54(suppl 3);248 (abstract).

    Google Scholar 

  17. Treiman DM, Meyers PD, Walton NY, Collins JF, Colling C, Rowan AJ, Handforth A, Faught E, Calabrese VP, Uthman BM, Ramsay RE, Mamdani MB. A comparison of four treatments for generalized convulsive status epilepticus. N Eng J Med 1998;339:792–798.

    Article  CAS  Google Scholar 

  18. Lowenstein DH, Bleck T, Macdonald RL. It’s time to revise the definition of status epilepticus. Epilepsia 1999;40:120–122.

    Article  PubMed  CAS  Google Scholar 

  19. Alldredge BK, Gelb AM, Isaacs SM, Corry MD, Allen F, Ulrich S, Gottwald MD, O’Neil N, Neuhaus JM, Segal MR, Lowenstein DH. A comparison of lorazepam, diazepam, and placebo for the treatment of out-of-hospital status epilepticus. N Engl J Med 2001;345:631–637.

    Article  PubMed  CAS  Google Scholar 

  20. Shinnar S, Berg AT, Moshe SL, Shinnar R. How long do new-onset seizures in children last? Ann Neurol 2001;49:659–664.

    Article  PubMed  CAS  Google Scholar 

  21. Mayer SA, Claassen J, Lokin J, Mendelsohn F, Dennis LJ, Fitzsimmons B-F. Refractory status epileptcius: Frequency, risk factors, and impact on outcome. Arch Neurol 2002;59:205–210.

    Article  PubMed  Google Scholar 

  22. Mazarati AM, Baldwin RA, Sankar R, Wasterlain CG. Time-dependent decrease in the effectiveness of antiepileptic drugs during the course of self-sustaining status epilepticus. Brain Res 1998;814:179–185.

    Article  PubMed  CAS  Google Scholar 

  23. Kapur J, Lothman EW, DeLorenzo RJ. Loss of GABAA receptors during partial status epilepticus. Neurology 1994;44:2407–2408.

    PubMed  CAS  Google Scholar 

  24. Kapur J, Macdonal RL. Rapid seizure-induced reduction of benzodiazepine and Zn2+ sensitivity of hippocampal dentate granule cell GABA-A receptors J Neurosci 1997;17:7532–7540.

    PubMed  CAS  Google Scholar 

  25. Jones DM, Esmaeil N, Maren S, Macdonald RL Characterization of pharmacoresistance to benzodiazepines in the rat Li-pilocarpine model of status epielpticus. Epilepsy Res 2002;50:301–312.

    Article  PubMed  CAS  Google Scholar 

  26. Goodkin HP, Liu X, Holmes GL. Diazepam terminates brief but not prolonged seizures in young, naïve rats. Epilepsia 2003;44:1109–1112.

    Article  PubMed  CAS  Google Scholar 

  27. De Lorenzo RJ, Pellock JM, Towne AR, Boggs JG. Epidemiology of status epilepticus. Clin Neurophysiol 1995;12:316–325.

    Google Scholar 

  28. DeLorenzo RJ, Hauser WA, Towne AR, Boggs JG, Pelock JM, Penberthy L, Garnett L, Fortner CA, Ko D. A prospective, population-based epidemiologic study of status epilepticus in Richmond, Virginia. Neurology 1996;46:1029–1035.

    PubMed  CAS  Google Scholar 

  29. Hesdorffer DC, Logroscino G, Cascino G, Annegers JF, Hauser WA. Incidence of status epilepticus in Rochester, Minnesota, 1965–1984. Neurology 1998;50:735–741.

    PubMed  CAS  Google Scholar 

  30. Coeytaux A, Jallon P, Galobardes B, Morabia A. Incidence of status epilepticus in French-speaking Switzerland (EPISTAR). Neurology 2000;55:693–697.

    PubMed  CAS  Google Scholar 

  31. Wu YW, Shek DW, Garcia PA, Zhao S, Johnston SC. Incidence and mortality of generalized convulsive status epilepticus in California. Neurology 2002;58:1070–1076.

    PubMed  CAS  Google Scholar 

  32. Berg AT, Shinnar S, Levy SR, Testa FM. Status epilepticus in children with newly diagnosed epilepsy. Ann Neurol 1999;45:618–623.

    Article  PubMed  CAS  Google Scholar 

  33. Sillanpaa M, Shinnar S. Status epilepticus in a population-based cohort with childhood-onset epilepsy in Finland. Ann Neurol 2002;52:303–310.

    Article  PubMed  Google Scholar 

  34. Shinnar S, Pellock JM, Moshe SL, Maytal J, O’Dell C, Driscoll SM, Alemany M, Newstein D, DeLorenzo RJ. In whom does status epilepticus occur: age-related differences in children. Epilepsia 1997;38:907–914.

    Article  PubMed  CAS  Google Scholar 

  35. Shinnar S, Maytal J, Krasnoff L, Moshe SL. Recurrent status epilepticus in children. Ann Neurol 1992;31:598–604.

    Article  PubMed  CAS  Google Scholar 

  36. Maytal J, Shinnar S, Moshe SL, Alvarez LA. Low morbidity and mortality of status epilepticus in childhood. Pediatrics 1989;83:323–331.

    PubMed  CAS  Google Scholar 

  37. DeLorenzo RJ, Towne AR, Pellock JM, Ko D. Status epilepticus in children, adults, and the elderly. Epilepsia 1992;33(suppl 4):15–25.

    Google Scholar 

  38. Morton LD, Garnett LK, Towne AR, Waterhouse EJ, Brown AJ, Byers SF, Pellock JM, DeLorenzo RJ. Mortality of status epilepticus in the first year of life. Epilepsia 2001;42(suppl 7):164–165.

    Google Scholar 

  39. Bui TT, Delgado CA, Simon HK. Infant seizures not so infantile: first-time seizures in children under six months of age presenting to the ED. Am J Emerg Med 2002;20:518–520.

    Article  PubMed  Google Scholar 

  40. Fujiwara T, Ishida S, Miyakoshi M, Sakuma N, Moriyama S, Morikawa T, Seino M, Wada T. Status epilepticus in childhood: A retrospective study of initial convulsive status and subsequent epilepsies. Folia Psychiatrica et Neurologica Japonica 1979;33:337–344.

    PubMed  CAS  Google Scholar 

  41. Vigevano F, DiPapua M, Fusco L, Bertini E, Maccagnani F. Status epilepticus in infancy and childhood. J Ped Neurosci 1985;1:101–112.

    Google Scholar 

  42. Dunn DW. Status epilepticus in children: Etiology, clinical features, and outcome. J Child Neurol 1988:3:167–173.

    Article  PubMed  CAS  Google Scholar 

  43. Yager JY, Cheang M, Seshia SS. Status epilepticus in childhood. Can J Neurol Sci 1988;15:402–405.

    PubMed  CAS  Google Scholar 

  44. Phillips SA and Shanahan RJ. Etiology and mortality of status epilepticus in children: A recent update. Arch Neurol 1989;46:74–76.

    PubMed  CAS  Google Scholar 

  45. Lacroix J, Deal C, Gauthier M, Rousseau E, Farrell CA. Admissions to a pediatric intensive care unit for status epilepticus: a 10-year experience. Crit Care Med 1994;22:827–832.

    Article  PubMed  CAS  Google Scholar 

  46. Mah JK, Mah MW Pediatric status epilepticus: a perspective from Saudi Arabia. Pediatr Neurol 1999;20:364–369.

    Article  PubMed  CAS  Google Scholar 

  47. Barnard C, Wirrell E. Does status epilepticus in children cause developmental deterioration and exacerbation of epilepsy? J Child Neurol 1999;14:787–794.

    PubMed  CAS  Google Scholar 

  48. Barry E, Hauser WA. Status epilepticus: the interaction of epilepsy and acute brain disease. Neurology 1993;43:1473–1478.

    PubMed  CAS  Google Scholar 

  49. Krumholz A, Sung GY, Fisher RS, Barry E, Bergey GK, Gratton LM. Complex partial status epilepticus accompanied by serious morbidity and mortality. Neurology 1995;45:1499–1504.

    PubMed  CAS  Google Scholar 

  50. Krumholz A. Epidemiology and evidence for morbidity of nonconvulsive status epilepticus. J Clin Neurophysiol 1999;16:314–322.

    Article  PubMed  CAS  Google Scholar 

  51. Drislane FW. Evidence against permanent neurologic damage from nonconvulsive status epilepticus. J Clin Neurophysiol 1999;16:323–331.

    Article  PubMed  CAS  Google Scholar 

  52. Nelson KB, Ellenberg JH. Prognosis in children with febrile seizures. Pediatrics 1978;61:720–727.

    PubMed  CAS  Google Scholar 

  53. Viani F, Beghi E, Romeo A, van Lierde A. Infantile febrile status epilepticus: risk factors and outcome. Dev Med Child Neurol 1987;29:495–501.

    Article  PubMed  CAS  Google Scholar 

  54. Van Esch A, Ramlal IR, van Steensel-Moll HA, Steyerberg EW, Derksen-Lubsen G. Outcome after febrile status epilepticus. Dev Med Child Neurol 1996;38:19–24.

    Article  PubMed  Google Scholar 

  55. Maytal J, Shinnar S. Febrile status epilepticus. Pediatrics 1990;86:611–616.

    PubMed  CAS  Google Scholar 

  56. Verity CM, Ross EM, Golding J. Outcome of childhood status epilepticus and lengthy febrile convulsions: findings of national cohort study. BMJ 1993;307:225–228.

    PubMed  CAS  Google Scholar 

  57. Scholtes FB, Renier WO, Meinardi H. Generalized convulsive status epilepticus: causes, therapy, and outcome in 346 patients. Epilepsia 1994;35:1104–1112.

    Article  PubMed  CAS  Google Scholar 

  58. Schmidley JW, Simon RP. Postictal pleocytosis. Ann Neurol 1981;9:81–84.

    Article  PubMed  CAS  Google Scholar 

  59. Barry E, Hauser WA. Pleocytosis after status epilepticus. Arch Neurol 1994;51:190–193.

    PubMed  CAS  Google Scholar 

  60. Maytal J, Novak G, Ascher C, Bienkowski R. Status epilepticus in children with epilepsy: the role of antiepileptic drug levels in prevention. Pediatrics 1996;98:1119–1121.

    PubMed  CAS  Google Scholar 

  61. Caksen H, Odabas D, Erol M, Anlar O, Tuncer O, Atas B. Do not overlook acute isoniazid poisoning in children with status epilepticus. J Child Neurol 2003;18:142–143.

    Article  PubMed  Google Scholar 

  62. Hankins DG, Saxena K, Faville RJ Jr, Warren BJ. Profound acidosis caused by isoniazid ingestion. Am J Emerg Med 1987;5:165–166.

    Article  PubMed  CAS  Google Scholar 

  63. Haverkos GP, DiSalvo RP, Imhoff TE. Fatal seizures after flumazenil administration in a patient with a mixed overdose. Ann Pharmacother 1994;28:1347–1349.

    PubMed  CAS  Google Scholar 

  64. Practice parameter: Neuroimaging in the emergency patient presenting with seizure. Ann Emerg Med 1996;27:114–118.

    Google Scholar 

  65. Sharma S, Riviello JJ, Harper MB, Baskin MN. The role of emergent neuroimaging in children with new-onset afebrile seizures. Pediatrics 2003:111:1–5.

    Article  PubMed  Google Scholar 

  66. Privitera MD, Strawsurg RH. Electroencephalographic monitoring in the emergency department. Emerg Med Clinics N Amer 1994;12:1089–1101.

    CAS  Google Scholar 

  67. DeLorenzo RJ, Waterhouse EJ, Towne AR, Boggs JG, Ko D, DeLorenzo GA, Brown A, Garnett L. Persistent nonconvulsive status epilepticus after the control of generalized convulsive status epilepticus. Epilepsia 1998;39:833–840.

    Article  PubMed  CAS  Google Scholar 

  68. Towne AR, Waterhouse EJ, Boggs JG, Garnett LK, Brown AJ, Smith JR Jr, DeLorenzo RJ. Prevalence of nonconvuslive status epilepticus in comatose patients. Neurology 2000;54:340–345.

    PubMed  CAS  Google Scholar 

  69. Thomas P. Status epileptics: Indications for emergency EEG. Neurophysiol Clin 1997;27:398–405.

    Article  PubMed  CAS  Google Scholar 

  70. Lothman E. The biochemical basis and pathophysiology of status epilepticus Neurology 1990;40(suppl 2):13–23.

    PubMed  CAS  Google Scholar 

  71. Wijdicks EF, Hubmayr RD. Acute acid-base disorders associated with status epilepticus. Mayo Clin Proc 1994;69:1044–1046.

    PubMed  CAS  Google Scholar 

  72. DeGiorgio CM, Correale JD, Gott PS, Ginsburg DL, Bracht KA, Smith T, Boutros R, Loskota WJ, Rabinowicz AL. Serum neuron-specific enolase in human status epilepticus. Neurology 1995;45:1134–1137.

    PubMed  CAS  Google Scholar 

  73. Rabinowicz AL, Correale JD, Bracht KA, Smith TD, DeGiorgio CM. Neuron-specific enolase in increased after nonconvulsive status epilepticus. Epilepsia 1995;36:475–479.

    Article  PubMed  CAS  Google Scholar 

  74. Browne TR. The pharmacokinetics of agents used to treat status epilepticus. Neurology 1990;40(suppl 2);28–32.

    PubMed  CAS  Google Scholar 

  75. Prensky AL, Raff MC, Moore MJ, Schwab RS Intravenous diazepam in the treatment of prolonged seizure activity N Eng J Med 1967;276:779–784.

    Article  CAS  Google Scholar 

  76. Sawyer GT, Webster DD, Schut LL. Treatment of uncontrolled seizure activity with diazepam. JAMA 1968;203:913–918.

    Article  PubMed  CAS  Google Scholar 

  77. Treiman DM. The role of benzodiazepines in the management of status epilepticus. Neurology 1990;40(suppl 2);32–42.

    PubMed  CAS  Google Scholar 

  78. Cock HR, Schapira AH. A comparison of lorazepam and diazepam as initial therapy in convulsive status epilepticus. Q J Med 2002;95:225–231.

    CAS  Google Scholar 

  79. Walker JE, Homan RW, Vasko MR, Crawford IL, Bell RD, Tasker WG. Lorazepam in status epilepticus. Ann Neurol 1979;6:207–213.

    Article  PubMed  CAS  Google Scholar 

  80. Lacey DJ, Singer WD, Horwitz SJ, Gilmore H. Lorazepam therapy of status epilepticus in children and adolescents. J Pediatr 1986;108:771–774.

    Article  PubMed  CAS  Google Scholar 

  81. Crawford TO, Mitchell WG, Snodgrass SR. Lorazepam in childhood status epilepticus and serial seizures: effectiveness and tachyphylaxis. Neurology 1987;37:190–195.

    PubMed  CAS  Google Scholar 

  82. Leppik IE, Derivan AT, Homan RW, Walker J, Ramsay RE, Patrick B. Double-blind study of lorazepam and diazepam in status epilepticus. JAMA 1983;249:1452–1454.

    Article  PubMed  CAS  Google Scholar 

  83. Kumar A, Bleck TP. Intravenous midazolam for the treatment of refractory status epilepticus. Crit Care Med 1992;20:483–488.

    Article  PubMed  CAS  Google Scholar 

  84. Cranford RE, Leppik IE, Patrick B, Anderson CB, Kostick B. Intravenous phenytoin: clinical and pharmacokinetic aspects. Neurology 1978;28:874–880.

    PubMed  CAS  Google Scholar 

  85. Cloyd JC, Gumnit RJ, McLain LW Jr. Status epilepticus. The role of intravenous phenytoin. JAMA 1980;244:1479–1491.

    Article  PubMed  CAS  Google Scholar 

  86. Salem RB, Wilder BJ, Yost RL, Doering PL, Lee C. Rapid infusion of phenytoin sodium loading doses. Am J Hosp Pharm 1981;38:354–357.

    PubMed  CAS  Google Scholar 

  87. Riviello JJ, Roe EJ, Sapin JI, Grover WD. Timing of maintenance phenytoin therapy after an intravenous loading dose. Pediatr Neurol 1991;7:262–265.

    Article  PubMed  Google Scholar 

  88. O’Brien TJ, Cascino GD, So EL, Hanna DR. Incidence and clinical significance of the purple glove syndrome in patients receiving intravenous phenytoin. Neurology 1998;51:1034–1039.

    PubMed  CAS  Google Scholar 

  89. Burneo JG, Anandan JV, Barkley GL. A prospective study of the incidence of purple glove syndrome. Epilepsia 2001;42:1156–1159.

    Article  PubMed  CAS  Google Scholar 

  90. Yoshikawa H, Abe T, Oda Y. Purple glove syndrome caused by oral administration of phenytoin. J Child Neurol 2000;15:762.

    PubMed  CAS  Google Scholar 

  91. Browne TR. Fosphneytoin (Cerebyx). Clin Neuropharmacol 1997;20:1–12.

    Article  PubMed  CAS  Google Scholar 

  92. Fischer JH, Patel TV, Fischer PA. Fosphenytoin: clinical pharmacokinetics and comparative advantages in the acute treatment of seizures. Clin Pharmacokinet 2003:42:33–58.

    Article  PubMed  CAS  Google Scholar 

  93. Takeoka M, Krishnamoorthy KS, Soman TB, Caviness VS. Fosphenytoin in infants. J Child Neurol 1998;13:537–540.

    PubMed  CAS  Google Scholar 

  94. Koul R, Deleu D. Subtherapeutic free phenytoin levels following fosphenytoin therapy in status epilepticus. Neurology 2002;58:147–148.

    PubMed  Google Scholar 

  95. Painter MJ, Scher MS, Stein AD, Armatti S, Wang Z, Gardiner JC, Paneth N, Minnigh B, Alvin J. Phenobarbital compared with phenytoin for the treatment of neonatal seizures. N Engl J Med 1999;341:485–489.

    Article  PubMed  CAS  Google Scholar 

  96. Shaner DM, McCurdy SA, Herring MO, Gabor AJ. Treatment of status epilepticus: a prospective comparison of diazepam and phenytoin vs phenobarbital and optional phenytoin. Neurology 1988;38:202–207.

    PubMed  CAS  Google Scholar 

  97. Holmes GL. Phenobarbital dose for status epilepticus. Am J Hosp Pharm 1994;51:1578.

    Google Scholar 

  98. Devinsky O, Leppik I, Willmore LJ, Pellock JM, Dean C, Gates J, Ramsay RE, the Intravenous Valproate Study Team. Safety of intravenous valproate. Ann Neurol 1995;38:670–674.

    Article  PubMed  CAS  Google Scholar 

  99. Campistol J, Fernandez A, Ortega J. Status epilepticus in children. Experience with intravenous valproate. Rev Neurol 1999;29:359–365.

    Article  PubMed  CAS  Google Scholar 

  100. Hovinga CA, Chicella MF, Rose DF, Eades SK, Dalton JT, Phelps SJ. Use of intravenous valproate in three pediatric patients with nonconvulsive status epilepticus. Ann Pharmacother 1999;33:579–584.

    Article  PubMed  CAS  Google Scholar 

  101. Venkataraman V, Wheless JW. Safety of rapid intravenous infusion of valproate loading doses in epilepsy patients. Epilepsy Res 1999;35:147–153.

    Article  PubMed  CAS  Google Scholar 

  102. Yu KT, Mills S, Thompson N, Cunanan C. Safety and efficacy of intravenous valproate in pediatric status epilepticus and acute repetitive seizures. Epilepsia 2003;44:724–726.

    Article  PubMed  CAS  Google Scholar 

  103. White JR, Santos CS. Intravenous valproate associated with significant hypotension in the treatment of status epilepticus. J Child Neurol 1999;14:822–823.

    PubMed  CAS  Google Scholar 

  104. Alfonso I, Alvarez LA, Gilman J, Dunoyer C, Yelin K, Papazian O. Intravenous valproate dosing in neonates. J Child Neurol 2000;15:827–829.

    PubMed  CAS  Google Scholar 

  105. Shephard SM. Management of status epilepticus. Emerg Med Clin North Am 1994;12:941–961.

    Google Scholar 

  106. Appleton R, Choonara I, Martland T, Phillips B, Scott R, Whitehouse W. The Status Epilepticus Working Party. The treatment of convulsive status epilepticus in children. Arch Dis Child 2000;83:415–419.

    Article  PubMed  CAS  Google Scholar 

  107. Walker MC, Smith SJ, Shorvon SD. The intensive care treatment of status epilepticus in the UK. Results of a national survey and recommendations. Anaesthesia 1995;50:130–135.

    Article  PubMed  CAS  Google Scholar 

  108. Delanty N, French JA, Labar DR, Pedley TA, Rowan AJ. Status epilepticus arising de novo in hospitalized patients: an analysis of 41 patients. Seizure 2001;10:116–119.

    PubMed  CAS  Google Scholar 

  109. Cornfield DN, Tegtmeyer K, Nelson MD, Milla CE, Sweeney M. Continuous propofol infusion in 142 critically ill children. Pediatrics 2002;110:1177–1181.

    Article  PubMed  Google Scholar 

  110. Code Team Manual. Children’s Hospital, Boston, 2003.

    Google Scholar 

  111. Erikkson KJ, Koivikko MJ. Status epilepticus in children: aetiology, treatment and outcome. Dev Med Child Neurol 1997;39:652–658.

    Article  Google Scholar 

  112. Garr RE, Appleton RE, Robson WJ, Molyneux EM. Children presenting with convulsions (including status epilepticus) to a paediatric accident and emergency department: an audit of a treatment protocol. Dev Med Child Neurol 1999;41:44–47.

    Article  PubMed  CAS  Google Scholar 

  113. Claassen J, Hirsch LJ, Mayer SA. Treatment of status epilepticus: a survey of neurologists. J Neurol Sci 2003;211:37–41.

    PubMed  Google Scholar 

  114. Karceski S, Morrell M, Carpenter D. The expert consensus guideline series: treatment of epilepsy. Epilepsy Behav 2001;2(suppl)A1–50.

    Article  Google Scholar 

  115. Appleton R, Martland T, Phillips B. Drug management for acute tonic-clonic convulsions ncluding convulsive status epilepticus in children. Cochrane Database Syst Rev 2002:CD001905.

    Google Scholar 

  116. Qureshi A, Wassmer E, Davies P, Berry K, Whitehouse WP. Comparative audit of intravenous lorazepam and diazepam in the emergency treatment of convulsive status epilepticus in children. Seizure 2002;11:141–144.

    Article  PubMed  CAS  Google Scholar 

  117. Gilbert DL, Gartside PS, Glauser TA. Efficacy and mortality in treatment of refractory generalized convulsive status epilepticus in children: a meta-analysis. J Child Neurol 1999;14:602–609.

    PubMed  CAS  Google Scholar 

  118. Kim SJ, Lee DY, Kim JS. Neurologic outcomes of pediatric patients treated with pentobarbital coma. Pediatr Neurol 2001;25:217–220.

    Article  PubMed  CAS  Google Scholar 

  119. Young GB, Blume WT, Bolton CF, Warren KG. Anesthetic barbiturates in refractory status epilepticus. Can J Neurol Sci 1980;7:291–292.

    PubMed  CAS  Google Scholar 

  120. van Ness PC. Pentobarbital and EEG burst suppression in treatment of status epilepticus refractory to benzodiazepines and phenytoin. Epilepsia 1990;31:61–67.

    PubMed  Google Scholar 

  121. Young RS, Ropper AH, Hawkes D, Woods M, Yohn P. Pentobarbital in refractory status epilepticus. Pediatr Pharmacol 1983;3:63–67.

    CAS  Google Scholar 

  122. Rashkin MC, Youngs C, Penovich P. Pentobarbital treatment of refractory status epilepticus. Neurology 1987;37:500–503.

    PubMed  CAS  Google Scholar 

  123. Lowenstein DH, Aminoff MJ, Simon RP. Barbiturate anesthesia in the treatment of status epilepticus: clinical experience with 14 patients. Neurology. 1988;38:395–400.

    PubMed  CAS  Google Scholar 

  124. Osorio I, Reed RC. Treatment of refractory generalized tonic-clonic status epilepticus with pentobarbital anesthesia after high-dose phenytoin. Epilepsia 1989;30:464–471.

    PubMed  CAS  Google Scholar 

  125. Yaffe K, Lowenstein DH. Prognostic factors of pentobarbital therapy for refractory generalized status epilepticus. Neurology 1993;43:895–900.

    PubMed  CAS  Google Scholar 

  126. Rivera R, Segnini M, Baltodano A, Perez V. Midazolam in the treatment of status epilepticus in children. Crit Care Med 1993;21:991–994.

    Article  PubMed  CAS  Google Scholar 

  127. Parent JM, Lowenstein DH. Treatment of refractory generalized status epilepticus with continuous infusion of midazolam. Neurology 1994;44:1837–1840.

    PubMed  CAS  Google Scholar 

  128. Holmes GL, Riviello JJ Jr. Midazolam and pentobarbital for refractory status epilepticus. Pediatr Neurol 1999;20:259–264.

    Article  PubMed  CAS  Google Scholar 

  129. Prasad A, Worrall BB, Bertram EH, Bleck TP. Propofol and midazolam in the treatment of refractory status epilepticus. Epilepsia 2001;42:380–386.

    Article  PubMed  CAS  Google Scholar 

  130. Claassen J, Hirsch LJ, Emerson RG, Bates JE, Thompson TB, Mayer SA. Continuous EEG monitoring and midazolam infusion for refractory nonconvulsive status epilepticus. Neurology 2001;57:1036–1042.

    PubMed  CAS  Google Scholar 

  131. Hamano S, Tanaka M, Mochizuki M, Sugiyama N, Eto Y. Midazolam treatment for status epilepticus in children. No To Hattatsu 2003;35:304–309.

    PubMed  Google Scholar 

  132. Minagawa K, Watanabe T. Eight-year study on the treatment with midazolam for status epilepticus and clusters of seizures in children. No To Hattatsu 2003;35:484–490.

    PubMed  Google Scholar 

  133. Crawford TO, Mitchell WG, Fishman LS, Snodgrass SR. Very high dose phenobarbital for refractory status epilepticus in children. Neurology 1988;38:1035–1040.

    PubMed  CAS  Google Scholar 

  134. Sudoh A, Sugai K, Miyamoto T, Mimaki M, Fukumizu M, Hanaoka S, Sasaki M. Non-intravenous high-dose phenobarbital therapy for status epilepticus refractory to continuous infusion of midazolam or pentobarbital: report of three cases. No To Hattatsu 2002;34:23–29.

    PubMed  Google Scholar 

  135. Singhi S, Banerjee S, Singhi P. Refractory status epileptics in children: role of continuous diazepam infusion. J Child Neurol 1998;13:23–26.

    PubMed  CAS  Google Scholar 

  136. Singhi S, Murthy A, Singhi P, Jayashree M. Continuous midazolam vs diazepam infusion for refractory convulsive status epilepticus. J Child Neurol 2002;17:106–110.

    PubMed  Google Scholar 

  137. Labar DR, Ali A, Root J. High-dose intravenous lorazepam for the treatment of refractory status epilepticus. Neurology 1994;44:1400–1403.

    PubMed  CAS  Google Scholar 

  138. Parviainen I, Uusaro A, Kalviainen R, Kaukanen E, Mervaala E, Ruokonen E. High-dose thiopental in the treatment of refractory status epilepticus in the intensive care unit. Neurology 2002;59:1249–1251.

    Article  PubMed  CAS  Google Scholar 

  139. De Giorgio CM, Altman K, Hamilton-Byrd E, Rabinowicz AL. Lidocaine in refractory status epilepticus: confirmation of efficacy with continuous EEG monitoring. Epilepsia 1992;33:913–916.

    Article  PubMed  Google Scholar 

  140. Pascual J, Ciudad J, Berciano J. Role of lidocaine (lignocaine) in managing status epilepticus. J Neurol Neurosurg Psychiatry 1992;55:49–51.

    PubMed  CAS  Google Scholar 

  141. Sata Y, Aihara M, Hatakeyama K, Hinohara Y, Kamiya Y, Shimoda C, Kanemura H, Nakazawa S. Efficacy and side effects of lidocaine by intravenous drip infusion in children with intractable seizures. No To Hattatsu 1997;29:39–44.

    PubMed  CAS  Google Scholar 

  142. Tanabe T, Suzuki S, Shimakawa S, Yamashiro K, Tamai H. Problems of intravenous lidocaine treatment in status epilepticus or clustering seizures in childhood. No To Hattatsu 1999;31:14–20.

    PubMed  CAS  Google Scholar 

  143. Kofke WA, Snider MT, Young RSK, Ramer JC. Prolonged low flow isoflurane anesthesia for status epilepticus. Anesthesiology 1985;62:653–656.

    Article  PubMed  CAS  Google Scholar 

  144. Roper AH, Kofke WA, Bromfield EB, Kennedy SK. Comparison of isoflurane, halothane, and nitrous oxide in status epilepticus. Ann Neurol 1986;19:98–99.

    Article  Google Scholar 

  145. Stecker MM, Kramer TH, Raps EC, O’Meeghan R, Dulaney E, Skaar DJ. Treatment of refractory status epilepticus with propofol: clinical and pharmacokinetic findings. Epilepsia 1998;39:18–26.

    Article  PubMed  CAS  Google Scholar 

  146. Parke TJ, Stevens JE, Rice ASC, Greenaway CL, Bray RJ, Smith PJ, Waldmann CS, Verghese C. Metabolic acidosis and fatal myocardial failure after propofol infusion in children: five case reports. BMJ 1992;305:613–616.

    Article  PubMed  CAS  Google Scholar 

  147. Hanna JP, Ramundo ML. Rhabdomyolysis and hypoxia associated with prolonged propofol infusion in children. Neurology 1998;50:301–303.

    PubMed  CAS  Google Scholar 

  148. Stelow EB, Johari VP, Smith SA, Crosson JT, Apple FS. Propofol-associated rhabdomyolysis with cardiac involvement in adults. Clin Chemistry 2000;46:577–581.

    CAS  Google Scholar 

  149. Vasile B, Rasulo F, Candiani A, Latronico N. The pathophysiology of propofol infusion syndrome: a simple name for a complex syndrome. Int Care Med 2003;29:1417–1425.

    Article  Google Scholar 

  150. Fujikawa DG. Neuroprotective effect of ketamine administered after status epilepticus onset. Epilepsia 1995;36:186–195.

    Article  PubMed  CAS  Google Scholar 

  151. Borris DJ, Bertram EH, Kapur J. Ketamine controls prolonged status epilepticus. Epilepsy Res 2000;42:117–122.

    Article  PubMed  CAS  Google Scholar 

  152. Sheth RD, Gidal BE. Refractory status epilepticus: response to ketamine. Neurology 1998;51:1765–1766.

    PubMed  CAS  Google Scholar 

  153. Browne TR. Paraldehyde, chlormethiazole, and lidocaine for status epilepticus. Adv Neurol 1983;34:509–517.

    PubMed  CAS  Google Scholar 

  154. Yeoman P, Hutchinson A, Byrne A, Smith J, Durham S. Etomidate infusions for the control of refractory status epilepticus. Int Care Med 1989;15:255–259.

    Article  CAS  Google Scholar 

  155. Congdon PJ, Forsythe WI. Intravenous clonazepam in the treatment of status epilepticus in children. Epilepsia 1980;21:97–102.

    PubMed  CAS  Google Scholar 

  156. Curless RG, Holzman BH, Ramsay RE. Paraldehyde therapy in childhood status epilepticus. Arch Neurol 1983;40:477–480.

    PubMed  CAS  Google Scholar 

  157. Lampl Y, Eshel Y, Gilad R, Sarova-Pinchas I. Chloral hydrate in intractable status epilepticus. Ann Emerg Med 1990;19:674–676.

    Article  PubMed  CAS  Google Scholar 

  158. Orlowski JP, Erenberg G, Lueders H, Cruse RP. Hypothermia and barbiturate coma for refractory status epilepticus. Crit Care Med 1984;12:367–372.

    Article  PubMed  CAS  Google Scholar 

  159. Winston KR, Levisohn P, Miller BR, Freeman J. Vagal nerve stimulation for status epilepticus. Pediatr Neurosurg 2001;34:190–192.

    Article  PubMed  CAS  Google Scholar 

  160. Claassen J, Hirsch LJ, Emerson RG, Mayer SA. Treatment of refractory status epilepticus with pentobarbital, propofol, or midazolam: a systematic review. Epilepsia 2002;43:146–153.

    Article  PubMed  CAS  Google Scholar 

  161. Bleck TP. Management approaches to prolonged seizures and status epilepticus. Epilepsia 1999;40(suppl 1):S59–63.

    Article  PubMed  Google Scholar 

  162. Bleck TP. Refractory status epilepticus in 2001. Arch Neurol 2002;59:188–189.

    Article  PubMed  Google Scholar 

  163. Sahin M, Riviello JJ Jr. Prolonged treatment of refractory status epilepticus in a child. J Child Neurol 2001;16:147–150.

    Article  PubMed  CAS  Google Scholar 

  164. Krishnamurthy KB, Drislane FW: Relapse and survival after barbiturate anesthetic treatment of refractory status epilepticus. Epilepsia 1996;37:863–867.

    Article  PubMed  CAS  Google Scholar 

  165. Krishnamurthy KB, Drislane FW. Depth of EEG suppression and outcome in barbiturate anesthetic treatment for refractory status epilepticus. Epilepsia 1999;40:759–762.

    Article  PubMed  CAS  Google Scholar 

  166. Sahin M, Menache CC, Holmes GL, Riviello JJ. Outcome of acute symptomatic refractory status epilepticus in children. Neurology 2003;61:398–401.

    PubMed  Google Scholar 

  167. Mirski MA, Williams MA, Hanley DF. Prolonged pentobarbital and phenobarbital coma for refractory generalized status epileptics. Crit Care Med 1995;23:400–404.

    Article  PubMed  CAS  Google Scholar 

  168. Ohori N, Fujioka Y, Ohta M. Experience in managing refractory status epilepticus caused by viral encephalitis under long-term anesthesia with barbiturate: a case report. Rinsho Shinkeigaku 1998;38:474–477.

    PubMed  CAS  Google Scholar 

  169. Alldredge BK, Wall DB, Ferriero DM. Effect on pre-hospital treatment of status epilepticus in childhood. Ped Neurol 1995;12:213–216.

    Article  CAS  Google Scholar 

  170. Yager JY, Seshia SS. Sublingual lorazepam in childhood serial seizures. Am J Dis Child 1988;142:931–932.

    PubMed  CAS  Google Scholar 

  171. Holmes GL. Buccal route for benzodiazepines in treatment of seizures. Lancet 1999;353:608–609.

    Article  PubMed  CAS  Google Scholar 

  172. Scott RC, Besag FM, Neville BG. Buccal midazolam and rectal diazepam for treatment of prolonged seizures in childhood and adolescence: a randomized trial. Lancet 1999;20:623–626.

    Article  Google Scholar 

  173. Lahat E, Goldman M, Barr J, Bistritzer T, Berkovitch. Comparison of intranasal midazolam with intravenous diazepam for treating febrile seizures in children: prospective randomized study. BMJ 2000;321:83–86.

    Article  PubMed  CAS  Google Scholar 

  174. Riviello JJ. Epileptic and epileptiform encephalopathies. Neurology, Emedicine, Boston, 2001. http://www.emedicine.com/neuro/topic547.htm.

    Google Scholar 

  175. Patry G, Lyagoubi S, Tassinari A. Subclinical “electrical status epilepticus” induced by sleep in children. A clinical and electroencephalographic study of six cases. Arch Neurol 1971;24:242–252

    PubMed  CAS  Google Scholar 

  176. Tassinari CA, Bureau M, Dravet C, Dalla Bernardina B, Roger J. Epilepsy with continuous spikes and waves during slow sleep-otherwise described as ESES (epilepsy with electrical status epilepticus during slow sleep. In: Roger J, Bureau M, Dravet C, Dreifuss FE, Perret A, Wolf P, eds. Epileptic Syndromes in Infancy, Childhood, and Adolescencence(2nd ed.). London: John Libbey and Co.; 1992:245–256.

    Google Scholar 

  177. Landau W, Kleffner FR. Syndrome of acquired aphasia with convulsive disorder in children. Neurology 1957;7:523–530.

    PubMed  CAS  Google Scholar 

  178. De Negri M, Baglietto MG, Battaglia FM. Treatment of electrical status epilepticus by short diazepam (DZP) cycles after DZP rectal bolus test. Brain Dev 1995;17:330–333.

    Article  PubMed  Google Scholar 

  179. Riviello JJ, Holder DL, Thiele E, Bourgeois BFD, Bergin AM, Duffy FH, Holmes GL. Treatment of continuous spikes and waves during slow wave sleep with high dose diazepam. Epilepsia 2001;42(suppl 7):56.

    Google Scholar 

  180. Lerman P, Lerman-Sagie T, Kivity S. Effect of early corticosteroid therapy for Landau-Kleffner Syndrome. Dev Med Child Neurology 1991;33:257–260.

    Article  CAS  Google Scholar 

  181. Fayad MN, Choueiri R, Mikati M. Landau-Kleffner syndrome: consistent response to repeated intravenous gamma-globulin doses: a case report. Epilepsia 1997;38:489–494.

    Article  PubMed  CAS  Google Scholar 

  182. Kramer U, Nevo Y, Neufeld MY, Fatal A, Leitner Y, Harel S. Epidemiology of epilepsy in childhood: a cohort of 440 consecutive patients. Ped Neurol 1998;18:46–50.

    Article  CAS  Google Scholar 

  183. Bishop DVM. Age of onset and outcome in acquired aphasia with convulsive disorder (Landau-Kleffner Syndrome). Dev Med Child Neurology 1985;27:705–712.

    Article  CAS  Google Scholar 

  184. Connolly AM, Chez MG, Pestronk A, Arnold ST, Mehta S, Deuel RK. Serum autoantibodies to brain in Landau-Kleffner variant, autism, and other neurologic disorders. J Pediatr 1999;134:607–613.

    Article  PubMed  CAS  Google Scholar 

  185. Bolanos A, Mikati M, Holmes G, Helmers S, Riviello J. Landau-Kleffner syndrome: clinical and EEG features. Neurology 1995;45(suppl 4):A180.

    Google Scholar 

  186. Bolanos A, Urion DK, Helmers SL, Lombroso CT, Mikati M, Duffy FH, Holmes GL, Riviello J. Serial electroencephalographic changes in children with Landau-Kleffner syndrome. Epilepsia 1997;38(suppl. 3):27.

    Google Scholar 

  187. Holmes GL, McKeever M, Saunders Z. Epileptiform activity in aphasia of childhood: an epiphenomenon? Epilepsia 1981;22:631–639.

    Article  PubMed  CAS  Google Scholar 

  188. Stefanatos GA, Foley C, Grover W, Doherty B. Steady-state auditory evoked responses to pulsed frequency modulations in children. Electroencephalogr Clin Neurophysiol 1997;104:31–42.

    Article  PubMed  CAS  Google Scholar 

  189. Deuel RK, Lenn NJ. Treatment of acquired epileptic aphasia. J Pediatr 1977;90:959–961.

    Article  PubMed  CAS  Google Scholar 

  190. Silver JM, Shin C, McNamara JO. Antiepileptogenic effects of conventional anticonvulsants in the kindling model of epilepsy. Ann Neurol 1991;29:356–363.

    Article  PubMed  CAS  Google Scholar 

  191. Snead OC 3rd, Hosey LC. Exacerbation of seizures in children by carbamazepine. N Engl J Med 1985;313:916–921.

    Article  PubMed  Google Scholar 

  192. Kochen S, Giagante B, Oddo S. Spike-and-wave complexes and seizure exacerbation caused by carbamazepine. Eur J Neurol 2002;9:41–47.

    Article  PubMed  CAS  Google Scholar 

  193. Gansaeuer M, Alsaadi TM. Carbamazepine-induced seizures: a case report and review of the literature. Clin Electroencephalogr 2002;33:174–177.

    PubMed  CAS  Google Scholar 

  194. Akman CI, Holmes GL. The effect of lamotrigine on the EEGs of children and adolescents with epilepsy. Epilepsy Behav 2003;4:420–423.

    Article  PubMed  Google Scholar 

  195. Mantovani JF, Landau WM. Acquired aphasia with convulsive disorder: course and prognosis. Neurology 1980;30:524–529.

    PubMed  CAS  Google Scholar 

  196. Deonna T-W, Roulet E, Fontan D, Marcoz J-P. Speech and oromotor deficits of epileptic origin in benign partial epilepsy of childhood with Rolandic spikes (BPERS). Neuropediatrics 1993;24:83–87.

    PubMed  CAS  Google Scholar 

  197. Soprano AM, Garcia EF, Caraballo R, Fejerman N. Acquired epileptic aphasia: neuropsychologic follow-up of 12 patients. Pediatr Neurol 1994;11:230–235.

    Article  PubMed  CAS  Google Scholar 

  198. Veggiotti P, Beccaria F, Guerrini R, Capovilla G, Lanzi G. Continuous spike-and-wave activity during slow-wave sleep: syndrome or EEG pattern? Epilepsia 1999;40:1593–1601.

    Article  PubMed  CAS  Google Scholar 

  199. Guilhoto LMFF, Morrell F. Electrophysiological differences between Landau-Kleffner syndrome and other conditions showing the CSWS electrical pattern. Epilepsia 1994;35(suppl. 8):126.

    Google Scholar 

  200. Marescaux C, Finck S, Maquet P, Schlumberger E, Sellal F, Metz-Lutz MN, Alembik Y, Salmon E, Franck G, Kurtz D. Landau-Kleffner Syndrome: A pharmacologic study of five cases. Epilepsia 1990;31:768–777.

    PubMed  CAS  Google Scholar 

  201. McKinney W, McGreal DA. An aphasic syndrome in children. Can Med J 1974;110:637–639.

    CAS  Google Scholar 

  202. Albaradie RS, Bourgeois BFD, Thiele E, Duffy FH, Holmes GL, Riviello JJ. Treatment of continuous spike and wave during slow wave sleep Epilepsia 2001;42(suppl 7):46–47.

    Google Scholar 

  203. Mtchedlishvili Z, Kapur J. A presynaptic action of the neurosteroid pregnenolone sulfate on GABAergic synaptic transmission. Mol Pharmacol 2003;64:857–864

    Article  PubMed  CAS  Google Scholar 

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  1. Division of Epilepsy and Clinical Neurophysiology, Critical Care Neurology Service, Department of Neurology, Children’s Hospital, Boston, MA

    James J. Riviello Jr. MD (Professor of Neurology)

  2. Harvard Medical School, Boston, MA

    James J. Riviello Jr. MD (Professor of Neurology)

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  1. James J. Riviello Jr. MD
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  1. Harvard Medical School, Comprehensive Epilepsy Program, Beth Israel Deaconess Medical Center, Boston, Massachusetts

    Frank W. Drislane MD (Associate Professor of Neurology) (Associate Professor of Neurology)

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Riviello, J.J. (2005). Status Epilepticus in Children. In: Drislane, F.W. (eds) Status Epilepticus. Current Clinical Neurology. Humana Press. https://doi.org/10.1385/1-59259-945-1:313

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