Status epilepticus and serial epilepsy

Status Epilepticus

This occurs most commonly in tonic-clonic seizures.

This is a serious form of epilepsy in which there is persistent epileptic activity for more than 30 minutes, or in which there are successive seizures without recovery of consciousness in between.

‘Status Epilepticus’ may be divided into two groups:

• Those where the ‘status’ was precipitated by an avoidable cause e.g. sudden withdrawal of anticonvulsant medication or alcohol withdrawal in people with alcohol dependency. This may be termed as ‘explained status epilepticus’

• Those where there is no identifiable cause i.e. the person may have poorly controlled epilepsy. This may be termed as ‘unexplained status epilepticus’.

‘Status epilepticus’ is the most serious event people with epilepsy are likely to encounter and has a significant mortality rate. The risk of recurrence of status epilepticus will depend on whether there are any avoidable precipitating factors e.g. sudden withdrawal of alcohol or medication (explained) or not (unexplained).

If no cause is found then recurrence cannot be excluded. The risk of recurrence decreases significantly with the passage of time and is minimal after 12 months from the date of the last episode.

Serial Epilepsy

Status Epilepticus should be distinguished from serial epileptic attacks, (also known as closely-spaced seizures or cluster attacks).

In serial epilepsy although attacks are very frequent, the person recovers consciousness in between attacks. It is not associated with the same risks as status, in which the attacks occur in such rapid succession that recovery of consciousness between the episodes does not occur.

Amended November 2008