Status epilepticus is considered a serious medical emergency. This occurs when a seizure lasts too long without stopping, or when a person has multiple seizures in a row without recovering. Below are seven facts about status epilepticus that can help you or a loved one prevent harm caused by prolonged seizure activity.
1. Status Epilepticus Defined
Status epilepticus is defined as a seizure lasting longer than 5 minutes, or two or more seizures happening without improvement in between. The first definition is based on time. Older classifications defined status epilepticus as 10 or 20 minutes of continued seizure activity. More recently, many experts are using 5 minutes as the cutoff. The reason is that if a seizure lasts longer than 5 minutes, it may be time to call for extra help.
Status epilepticus also is defined as when more than one seizure occurs in a row, without the person improving between the seizures. This situation may actually happen more frequently than the first definition. It can be hard to tell if a person doesn’t come to between seizures because of ongoing seizure activity in the brain or if the brain is recovering from the first seizure. When recovery from a seizure takes longer than expected, it is possible that the seizure may be occurring electrically, with the only symptom being unconsciousness or confusion.
2. Status Epilepticus Is A True Emergency
Prolonged seizures can be harmful. Many other body systems can be involved, especially if the seizure includes generalized tonic-clonic activity. Body metabolism can be altered, heart rhythms can change, and even breathing can be effected. The most important step in treating status is to recognize that it’s a true medical emergency.
3. Prevent Status Epilepticus By Timing Seizures
If a seizure lasts longer than 5 minutes, it is not likely to stop on its own. Almost all seizures stop on their own. Most seizures last less than 2 or 3 minutes. Although everyone is unique, studies have shown that if a seizure lasts longer than 5 minutes, rescue medicines are usually needed to stop the seizure.
4. Treat Status Epilepticus As Soon As Possible
If status epilepticus is treated earlier, it is easier to stop. Studies have shown that the sooner treatment of status epilepticus is started, the more likely the prolonged seizure will respond to medication. It’s been shown many times in the literature that changes in nerve cells in the brain occur with long seizures: the number of receptors on nerve cells decrease. When this happens, medications that act on these receptors will not work as well. This is another key reason to recognize status early.
5. Not All Status Epilepticus Is The Same
Just as everyone’s seizures are unique, so is status epilepticus. There are multiple types of seizures. Although the guidelines referred to above are not specific for any seizure type, knowing what of seizure type you or your loved one has can be important. Certain medications may work better for certain types of seizure. If the treating provider knows what type of seizure or epilepsy the person has, better decisions can be made with a more individualized approach to stop the status.
6. Create A Plan With Your Healthcare Team
Tell your doctor if you or your loved one with epilepsy has ever had status epilepticus, or if you are concerned that this may occur. Creating a plan to treat breakthrough seizures or cluster seizures is an important part of epilepsy management. Again, the treatment of epilepsy should be individualized for each person. Things to discuss could include when to call for emergency help, when to give a rescue medication, and how to stay safe if a seizure occurs.
7. Rescue Therapies Are Used For Seizure Safety
Rescue therapies are “as needed” medications that are only given during specific situations like this. The goal of a rescue therapy is to stop seizures quickly to prevent a seizure emergency. The ideal rescue therapy is easy to use, fast acting, has few side effects, and works well for your type of seizures. If you think you may benefit from having a rescue therapy on hand for emergency use, contact your healthcare provider.
Take these steps to prepare for a seizure emergency like Status Epilepticus:
- Know what type of seizures you have.
- Tell your healthcare team if you’ve ever had status or cluster seizures or been hospitalized for long or repeated seizures.
- Ask your healthcare provider if a rescue therapy is right for you.
- Update your seizure action plan each year or whenever you have a change in medicines.
- If you don’t have a seizure action plan, download a form from our Toolbox, fill out as much as you can, and take it to your next appointment with your epilepsy doctor or nurse.
- Log your seizure activity using an app to keep track of your symptoms, side effects, and more.