If status epilepticus is the child’s first seizure, then the doctors will probably want to do a lumbar puncture (spinal tap) to look for infection. They will study the blood for possible chemical changes and, perhaps, do an EEG then or the next day. They may even do a CT scan.

If the child has had other seizures or has epilepsy, then looking for a cause of the status may be slightly less important.

The most common cause of status epilepticus in a person who has previously had seizures is that the level of medication in the blood is too low. This may be because the child is not taking his medication, or that it has been forgotten, or that an interaction with some other medication has lowered the level. Substitution of a generic drug that is less well absorbed may also result in status epilepticus.

In almost all instances, the status epilepticus can be controlled within one-half hour to one hour from the time the child arrives in the emergency room and treatment is started. Only in an unusual situation, when there is an acute process occurring in the brain such as infection or damage from a head injury, do seizures continue, and are they difficult to control. Treatment of severe prolonged status epilepticus can be enormously challenging for the physician, requiring large doses of medication given in an intensive care unit and sometimes requiring general anesthesia to stop the seizures.

The outcome of status epilepticus, even in these severe episodes, depends more on the cause than on the duration of the seizures. Rest assured that most children who have status recover and are just as normal as they were before the seizures. It appears to be very, very rare for children who have status without a known cause to suffer any permanent damage, even from prolonged seizures.

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