Status Epilepticus

Medically reviewed by Drugs.com. Last updated on May 6, 2024.

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What is status epilepticus?

Status epilepticus is a seizure that lasts longer than 5 minutes. It can also be a second seizure before you are fully awake and aware after the first. Status epilepticus is a medical emergency. It can cause permanent brain damage or death.

What increases my risk for status epilepticus?

• Medical conditions such as cerebral palsy, cerebrovascular disease, or abnormal blood vessel formation in the brain
• A family history of epilepsy
• Not enough antiepileptic medicine, or not taking your medicine as directed
• An infection such as meningitis
• Alcohol or drug abuse
• Head injury or a brain tumor
• Certain medicines, such as antidepressants or antipsychotics

What are the different types of seizures?

You may have warning signs and symptoms before the seizure starts. This is called an aura. Examples include dizziness, anxiety, or flashing bright lights. You may also have any of the following, depending on the kind of seizure you have:

• A generalized seizure may affect both sides of the brain. After you have a generalized seizure you may have a headache or feel irritable. The following are different types of generalized seizures:
  • A tonic, clonic, or tonic-clonic seizure usually involves the whole body. A clonic seizure involves jerking body movements. A tonic seizure involves stiffening of the body. A tonic-clonic seizure is a combination of clonic and tonic seizures. It is also called a grand mal seizure. Tonic-clonic is the most common seizure type that leads to status epilepticus. During any of these types of seizures, you may lose consciousness. Your eyes may roll up and back into your head and you may sweat all over your body.
  • A myoclonic seizure involves a sudden jerk of all or part of the body.
  • An atonic seizure is usually brief and causes a sudden loss of posture. You may fall suddenly to the ground.
  • An absence seizure is also known as a petit mal seizure. You may stare blankly into space, and will not pay attention to anything happening around you. Your eyes may flutter or blink repeatedly, and you may smack your lips. You may have several absence seizures throughout a day.
  • An atypical absence seizure looks like an absence seizure, but also includes repetitive behaviors. These behaviors include eye opening and closing, eyes rolling outward or inward, and body stiffening.
• A partial seizure may affect one part of the brain. The symptoms may depend on where in the brain the abnormal activity is happening. It may be simple or complex. A simple partial seizure may not cause a loss of consciousness. A complex partial seizure may cause a loss of consciousness. Both types of partial seizures may cause jerky muscle movements, confusion, hallucinations, sweating, or repetitive behaviors.

How is status epilepticus diagnosed?

You may need any of the following:

• An EEG records the electrical activity of your brain. It is used to find changes in the normal patterns of your brain activity.
• A CT scan or an MRI may show abnormal areas in your brain or a tumor. You may be given contrast liquid to help the areas show up better. Tell the healthcare provider if you have ever had an allergic reaction to contrast liquid. Do not enter the MRI room with anything metal. Metal can cause serious injury. Tell the healthcare provider if you have anything metal in or on your body.

How is status epilepticus treated?

Your healthcare provider will treat the underlying cause of your seizure if it is known. You may need IV medicine to stop status epilepticus. You may need multiple medicines to control or stop your seizures. You may also need other treatments if status epilepticus causes problems with breathing or circulation.

Treatment options

The following list of medications are related to or used in the treatment of this condition.

• Ativan
• Diastat
• lorazepam
• Dilantin
• Valium

View more treatment options

What can I do to help prevent another episode of status epilepticus?

• Take your medicine every day at the same time. This will help prevent seizures. Use an alarm to help you remember to take your medicine. Do not skip any doses or take less than directed.
• Identify and avoid your seizure triggers. Common triggers include alcohol, drugs, flashing lights, and moving patterns. Talk to your healthcare provider if you need help to quit using drugs or drinking alcohol.
• Drink plenty of liquids and eat a variety of healthy foods. Dehydration and poor nutrition can trigger a seizure. Healthy foods include fruits, vegetables, whole-grain breads, low-fat dairy products, beans, lean meats, and fish. Ask if you need to be on a special diet. Also ask how much liquid you need each day and which liquids are best for you.
• Manage stress. A large amount of stress can increase your risk for a seizure. Do activities that help relax you such as yoga, reading, or meditation. Talk to your healthcare provider if you think you need therapy or other ways to manage your stress.
• Set a sleep schedule. A lack of sleep is a powerful trigger of seizures in some people. Try to go to sleep and wake up at the same times every day. Keep your bedroom quiet and dark. Talk to your healthcare provider if you have trouble sleeping.

What can others do to keep me safe if I have another seizure?

Give the following instructions to family, friends, and coworkers:

• Do not panic.
• Do not hold me down or put anything in my mouth.
• Gently guide me to the floor or a soft surface.
• Place me on my side to help prevent me from swallowing saliva or vomit.
• Protect me from injury. Remove sharp or hard objects from the area surrounding me, or cushion my head.
• Loosen the clothing around my head and neck.
• Time how long my seizure lasts. Call 911 if my seizure lasts longer than 5 minutes or if I have a second seizure.
• Stay with me until my seizure ends. Let me rest until I am fully awake.
• Perform CPR if I stop breathing or you cannot feel my pulse.
• Do not give me anything to eat or drink until I am fully awake.

Have someone else call 911 if:

• You have another seizure that lasts longer than 5 minutes.
• You have a second seizure that happens within 24 hours of your first.
• You have trouble breathing after a seizure.
• You cannot be woken after a seizure.
• You have a seizure in water, such as a swimming pool or bath tub.
• You have diabetes or are pregnant and have a seizure.
• You have more than 1 seizure before you are fully awake or aware.

When should I seek immediate care?

• You are injured during a seizure.

When should I contact my healthcare provider?

• You start to have seizures more often.
• You feel extremely sad, anxious, or are unable to cope with your condition.
• You have questions or concerns about your condition or care.

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your healthcare providers to decide what care you want to receive. You always have the right to refuse treatment. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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