Status epilepticus is a continuous seizure, or a series of seizures, lasting more than 30 minutes. It is a medical emergency, as prolonged seizures can result in brain damage or even death. Status epilepticus can occur at any age, and in any seizure type.

In children, convulsive status epilepticus is the most common medical emergency affecting the brain and nervous system. However most information about how to treat it and its outcomes comes from research in adult patients, and so may not be relevant for children, since many paediatric epilepsy syndromes are different from those seen in adults.

Researchers from the Institute of Child Health in London led by Dr Richard Chin set up a surveillance study of status epilepticus in children. They looked at the records of 226 children admitted to hospitals in North London with an episode of status epilepticus, including data from A&E and intensive care units, ambulance services and nurses.

The researchers worked out that there were 17-23 episodes of status epilepticus per 100,000 children every year in the UK (a rate of 4-6 episodes per 100,000 has been calculated for adults). For 78% of the children identified by the study, this was their first ever episode of convulsive status epilepticus. More than half had been neurologically healthy before it. In these previously healthy children, 57% experienced their episode after a prolonged febrile seizure (a seizure due to a fever), which in 12% of cases was due to acute bacterial meningitis. The risk of having another episode within a year was estimated to be at least 16%. Three percent of patients died following their episode (previously, mortality rates of 13% and 38% have been reported in young adults and the elderly respectively).

Dr Chin and his team, writing in the journal The Lancet in July, concluded that convulsive status epilepticus is more common in children than in adults but that it has a lower risk of death. It also has different causes: febrile seizures, for example, only occur in children; and over half the cases seen in the study occurred in children with no previous neurological ill-health.

This study has highlighted a number of features doctors need to bear in mind when managing paediatric cases of status epilepticus. The researchers will continue to study this group of children, to find out what the longer term outcomes of status epilepticus are, and how they are affected by the children's background and treatment. It's hoped that this information will allow better treatment of these patients.

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