The new definition of Status Epilepticus.
The definition of Status Epilepticus has changed to any seizure lasting longer than 5 minutes. Status epilepticus used to be defined as any seizure lasting longer than 30 minutes. Now, it’s been reduced to any seizure lasting longer than 5 minutes. A seizure lasting more than 5 minutes should be treated.
***Treatment starts at 5 minutes of uninterrupted seizing.
The International League Against Epilepsy (ILAE) report says:
” Status epilepticus is a condition resulting either from the failure of the mechanisms responsible for seizure termination or from the initiation of mechanisms, which lead to abnormally, prolonged seizures (after time point t1). It is a condition, which can have long-term consequences (after time point t2), including neuronal death, neuronal injury, and alteration of neuronal networks, depending on the type and duration of seizures. This definition is conceptual, with two operational dimensions: the first is the length of the seizure and the time point (t1) beyond which the seizure should be regarded as “continuous seizure activity.” The second time point (t2) is the time of ongoing seizure activity after which there is a risk of long-term consequences. In the case of convulsive (tonic-clonic) SE, both time points (t1 at 5 min and t2 at 30 min) are based on animal experiments and clinical research. This evidence is incomplete, and there is furthermore considerable variation, so these time points should be considered as the best estimates currently available. ” ILAE
“Time point t1 indicates when treatment should be initiated, and time point t2 indicates when long-term consequences may appear.” ILAE
“The above definition is conceptual, with two operational dimensions: the first is the length of the seizure and the time point (t1) at which the seizure should be regarded as an “abnormally prolonged seizure.” The second time point (t2) is the time of ongoing seizure activity beyond which there is a risk of long-term consequences.”ILAE
References
Trinka, E. et al. (2015), A definition and classification of status epilepticus – Report of the ILAE Task Force on Classification of Status Epilepticus. Epilepsia, 56: 1515–1523. http://onlinelibrary.wiley.com/doi/10.1111/epi.13121/abstract
Epilepsia. 2015 Oct;56(10):1515-23. https://www.ncbi.nlm.nih.gov/pubmed/26336950