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Pediatric status epilepticus: identification and evaluation

Freilich, Emily R.; Schreiber, John M.; Zelleke, Tesfaye; Gaillard, William D.

doi: 10.1097/MOP.0000000000000152
NEUROLOGY: Edited by Robert C. Tasker

Purpose of review Status epilepticus is an acute neurologic emergency, the incidence of which is increasing in the United States as the definition evolves and our detection abilities improve. We will present the current definition of status epilepticus, including a recently modified operational definition for use in the clinical setting. We will also provide updates on identifying children in status epilepticus, etiologic considerations, and the rationale for diagnostic testing.

Recent findings Recent data reveal the benefits of MRI vs. computed tomography in new-onset status epilepticus, as well as high rates of identification of electrographic seizures in patients with unexplained acute encephalopathy in pediatric ICU settings. Genetic testing should be considered in young children with recurrent status epilepticus.

Summary Prompt recognition and diagnostic evaluation of the child in status epilepticus will help identify causes, which may require specific treatment, and help in the management of this life-threatening condition. Laboratory work, neuroimaging, electroencephalogram or continuous video electroencephalogram, lumbar puncture, and genetic testing may be considered in the evaluation of the child in status epilepticus.

Department of Neuroscience, Children's National Health System, Washington, District of Columbia, USA

Correspondence to William D. Gaillard, MD, Department of Neuroscience, Children's National Health System, 111 Michigan Ave NW, Washington, DC 20010, USA. Tel: +1 202 476 2120; e-mail:

© 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins