• B G R Neville, R F M Chin, and R C Scott.
• Neurosciences Unit, University College, Institute of Child Health, and Great Ormond Street Hospital for Children, NHS Trust, London, UK. b.neville@ich.ucl.ac.uk
• Acta Neurol. Scand., Suppl.c. 2007 Jan 1; 186: 21-4.

AbstractConvulsive status epilepticus (CSE) in childhood is a medical emergency and its aetiology and outcome mean that it should be studied separately from adult CSE. The incidence in developed countries is between 17 and 23/100,000 with a higher incidence in younger children. Febrile CSE is the commonest single group with a good prognosis in sharp distinction to CSE related to central nervous system infections which have a high mortality. The aim of treatment is to intervene at 5 min and studies indicate that intravenous (i.v.) lorazepam may be a better first-line treatment than rectal diazepam and i.v. phenytoin a better second-line treatment than rectal paraldehyde. An epidemiological study strongly supports the development of prehospital treatment with buccal midazolam becoming a widely used but unlicensed option in the community. More than two doses of benzodiazepines increase the rate of respiratory depression without obvious benefit. The 1 year recurrence rate is 17% and the hospital mortality is about 3%.

27 keywords...

hide…