What Is Status Epilepticus?

Reviewed by: HU Medical Review Board | Last reviewed: November 2021

A seizure is a change in movement, mood, or behavior caused by abnormal electrical activity in the brain. Most seizures last a few seconds to no longer than 2 minutes and end on their own without treatment. When a seizure lasts longer it is called status epilepticus.1

There are 2 kinds of status epilepticus. The first is 1 seizure lasting more than 5 minutes. The second is more than 1 seizure within 5 minutes without the person recovering in between.1,2

Until recently, seizures had to last at least 20 to 30 minutes before being considered status epilepticus. The definition changed because most seizures last 2 minutes or less. The longer a seizure lasts, the more dangerous it becomes, and the less likely it will stop without medicine.1

Types of status epilepticus

There are 2 types of status epilepticus:1,3

  • Convulsive status epilepticus involves jerking motions, falling, grunting, drooling, and abnormal eye movements. This type is more likely to cause injury.
  • Nonconvulsive status epilepticus involves a change in mental status such as confusion, inability to speak, the appearance of daydreaming, or irrational behavior.

Status epilepticus is a medical emergency. It requires quick treatment in a hospital to prevent serious complications or even death.1

What causes status epilepticus?

Status epilepticus is somewhat rare, and most people with epilepsy will never have it. About 1 in 10 adults and 1 in 5 children with epilepsy will have 1 or more episodes of status epilepticus in their life. However, it is more common in people with poorly controlled epilepsy.2

People without epilepsy can have status epilepticus too. This includes:2,3

  • People with an infection
  • Adults who have had a stroke or brain mass
  • Adults with very low blood sugar
  • Adults in drug or alcohol withdrawal

Certain other groups of people are at risk for this complication, such as those with organ failure, brain infections, or other chronic diseases.3

How is it diagnosed and treated?

A diagnosis may be obvious if someone is having convulsive status epilepticus. In these cases, treatment to stop the seizures may begin without an EEG (electroencephalogram) test. Treatment may include:2,3

  • Oxygen
  • An IV line to receive anti-seizure drugs quickly
  • Breathing support (intubation) in severe cases

If blood tests show that the seizures are caused by very low blood sugar, the person may be given glucose (sugar).

Someone in nonconvulsive status epilepticus may be harder to diagnose. In these cases, the doctor may run an EEG test before prescribing treatment.

Once the seizures have stopped, the doctor may order an MRI or CT scan, spinal tap, or more blood tests. These tests can help confirm what caused status epilepticus.2

Other things to know about status epilepticus

If you have epilepsy, it is important to let loved ones know how to help you if you have a seizure. First, they should gently place you on your side, away from hard or sharp objects. This helps you from accidentally hurting yourself. They should not put anything in your mouth. Then, they should begin timing your seizure.

If the seizure lasts longer than 5 minutes, they should call for an ambulance. They should also call 911 if you have 2 or more seizures in 5 minutes without waking up.4

In addition to status epilepticus, other complications may also occur with epilepsy. These include:

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