Identification and Evaluation of the Child in Status Epilepticus

Status epilepticus (SE) is an acute neurologic emergency that requires prompt recognition and initiation of treatment. Recognition can be difficult because SE comes in many forms and has been defined differently over the past decade. We present the general consensus definition of SE and how to use the definition, including a modified operational definition, to guide management. Furthermore, evaluation of the child who presents in SE is important to determine the etiology and identify underlying causes that may require additional treatment. Evaluation may include measurement of electrolytes, lumbar puncture, drug levels, electroencephalography, and/or neuroimaging. Recent data are presented that update the current practice parameter guidelines and also indicate that neuroimaging is important in cases of new-onset SE and can help significantly in the diagnosis and management.