Status Epilepticus

A seizure involves abnormal electrical activity in the brain that affects the mind and body. Many problems can cause you to have a seizure. These include high fever, abnormal levels of sodium or blood sugar, and head injuries. If you have a condition called epilepsy, you may have seizures repeatedly.

A seizure that lasts at least 5 minutes, a second seizure without recovering consciousness from the first, or if a person is having a repeated seizure lasting 30 minutes or longer is called status epilepticus, or a prolonged seizureThis is a medical emergency that may lead to permanent brain damage or death. 

Facts about status epilepticus

This condition is especially common in young children and elderly adults.

In infants and children, the main cause of status epilepticus is an infection with a fever. In adults, these are common causes of the problem:

  • Brain injury (stroke, head trauma, infection, or tumor)

  • Imbalance of substances in the blood (low blood sugar or electrolyte imbalances)

  • Drinking too much alcohol or drug overdose

  • Withdrawal syndromes (stopping use of alcohol, barbituates, or benzodiazepines)

  • Low antiepileptic medicinal levels in patients with epilepsy

Types of status epilepticus

This condition can happen as:

  • Convulsive status epilepticus. Status epilepticus with convulsions may be more likely to lead to long-term injury. Convulsions may involve jerking motions, grunting sounds, drooling, and rapid eye movements.

  • Nonconvulsive status epilepticus. People with this type may appear confused or look like they're daydreaming. They may be unable to speak and may be behaving in an irrational way.


These are possible symptoms of status epilepticus:

  • A seizure that lasts more than 5 minutes, or more than 1 seizure in a row without regaining consciousness in between

  • Muscle spasms

  • Falling

  • Confusion

  • Unusual noises

  • Loss of bowel or bladder control

  • Clenched teeth

  • Irregular breathing

  • Unusual behavior

  • Difficulty speaking

  • A "daydreaming" look


Your healthcare provider will probably diagnose this problem by carefully examining you and asking whether you have epilepsy or other health problems. The healthcare provider may also ask about any medicine you’re taking and if you’ve been using alcohol or other recreational drugs

Your healthcare provider may also order an electroencephalogram (EEG). A healthcare provider will place painless electrodes onto your scalp. These measure the brain's electrical activity.

You may need other tests to search for possible causes. These include a lumbar puncture, or spinal tap, to look for signs of infection. A CT scan or MRI may be needed to see problems in the brain.


The healthcare provider will want to end the seizure as quickly as possible and treat any underlying problems that are causing it. Your healthcare provider may place you on oxygen, take blood samples, and put an intravenous (IV) line into a vein. You may be given glucose (sugar) if low blood sugar may be causing the seizure.

Healthcare providers may use anti-seizure medicines to treat the problem, including:

  • Diazepam

  • Lorazepam

  • Midazolam 

  • Phenytoin

  • Fosphenytoin

  • Phenobarbital

  • Valproate

  • Levetiracetam 

These medicines are given through an IV, an injection into a muscle, or a suppository in the rectum. 


If you have epilepsy, taking your medicines as directed may help you avoid status epilepticus. If you’ve had status epilepticus, you may need to begin taking seizure medicines or change medicines you’re already taking. Avoiding other causes of this condition, like alcohol abuse or low blood sugar, may also help prevent it. It is important to always be under the care of a healthcare provider if you have experienced seizures. 

Managing status epilepticus

This is an emergency that requires immediate medical care.