What is Status Epilepticus?

Status epilepticus is a serious condition where a seizure lasts longer than five minutes or multiple seizures happen back-to-back without recovery in between. This situation requires immediate medical care. Without prompt treatment, it can harm the brain or become life-threatening.

Status epilepticus can happen for several reasons. In some people, it is linked to epilepsy, especially if medications are missed or not working well. Other causes include infections, high fever in children, stroke, head injury, or changes in blood sugar or electrolyte levels. Alcohol or drug withdrawal can also trigger prolonged seizures.

Symptoms

Symptoms can vary depending on the type of seizure, but they often appear suddenly and may worsen quickly.

Common symptoms include:

• Uncontrolled jerking or stiffening of the body
• Loss of awareness or responsiveness
• Confusion or unusual behavior
• Trouble speaking or communicating
• Irregular or slowed breathing
• Loss of bladder or bowel control
• Staring spells or appearing “zoned out”

How is it diagnosed?

Healthcare providers act quickly to evaluate someone with ongoing seizure activity. Diagnosis often begins with a physical and neurological exam, along with a review of medical history and medications.

Tests may include an EEG to measure brain activity, as well as imaging such as a CT scan or MRI to look for problems in the brain. Blood tests can help identify metabolic issues, and in some cases, a spinal tap may be used to check for infection.

How is it treated?

Treatment focuses on stopping the seizure as quickly as possible while supporting breathing and circulation. Emergency care may include oxygen, IV fluids, and medications given through a vein.

First-line treatments usually involve fast-acting anti-seizure medications. If seizures continue, additional medications may be used. Providers also address the underlying cause, such as correcting low blood sugar or treating an infection.

Recovery depends on how quickly treatment begins and what caused the seizure. Some people recover fully, while others may experience complications if the episode lasts too long.