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N.B. Healthy child with first attack of convulsion → don't give
anticonvulsants especially with normal neurological examination and normal
EEG → as 50% of these children will not have another attack
Status Epilepticus
Definition :
A seizure that lasts longer than 5 minutes, or having more than 1 seizure
within a 5 minutes period, without returning to a normal level of
consciousness between episodes is called status epilepticus. This is a medical
emergency that may lead to permanent brain damage or death.
Types and Etiology:
Prolonged febrile convulsion
Idiopathic Status Epilepticus due to sudden withdrawal of anticonvulsants or
associated infections
Symptomatic Status Epilepticus:
CNS infections.
Metabolic effects: IEM e.g. phenyketouria, hypoglycemia, hypocalcaemia.
Complications: due to excessive release of excitatory neurotransmitters
leading to
Acute pathologic changes: petichial hemorrhage, edema and increase in
intracranial pressure
Cell damage and necrosis with prolonged seizure → mental retardation,
epilepsy, extra pyramidal manifestations.
