Status epilepticus is when a seizure lasts for 5 minutes or more or when a person does not regain consciousness between seizures. It is a medical emergency and requires immediate medical attention.

Seizures occur due to sudden, uncontrolled bursts of electrical activity inside a person’s brain. These bursts of electricity interrupt the signals between the brain cells, which can cause involuntary changes in:

  • movement
  • sensations
  • body functions
  • behavior
  • awareness

This article explores what status epilepticus is in more detail, including the different types. The article also discusses the causes, complications, treatment, and prevention of status epilepticus.

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Status epilepticus occurs when a seizure lasts for 5 or more minutes or when someone has multiple seizures in a row without regaining consciousness in between them.

Without treatment, seizures that last more than 5 minutes may be unlikely to stop by themselves. The Epilepsy Foundation notes that seizures that last longer than 30 minutes may increase a person’s risk of death.

Additionally, the Centers for Disease Control and Prevention (CDC) notes that seizures typically last between a few seconds and a few minutes. If a seizure lasts longer than 5 minutes, it may damage a person’s neurons.

An individual may develop status epilepticus with or without having a history of epilepsy. According to a 2023 review of research, 16–38% of children and 42–50% of adults with status epilepticus have a history of epilepsy.

There are two types of status epilepticus that someone can develop: convulsive status epilepticus and nonconvulsive status epilepticus.

Convulsive status epilepticus

Convulsive status epilepticus involves a person’s body becoming stiff and twitching in an uncontrolled manner.

The Epilepsy Foundation notes that this form of status epilepticus is the most common type of emergency that occurs with tonic-clonic seizures lasting more than 5 minutes. Tonic-clonic seizures cause a person’s body to jerk and stiffen, alongside a loss of consciousness.

A person may be experiencing convulsive status epilepticus if:

  1. They experience rhythmic shaking as part of a tonic-clonic seizure for 5 minutes or more.
  2. They have multiple tonic-clonic seizures without regaining consciousness for more than 5 minutes.

Convulsive status epilepticus is a medical emergency. A person should call 911 immediately if they suspect someone is experiencing convulsive status epilepticus.

Nonconvulsive status epilepticus

Nonconvulsive status epilepticus occurs when a person experiences an absence seizure or a complex partial seizure but does not convulse. Instead, the individual becomes unresponsive. This may occur after a person has been convulsing to begin with.

Someone who has nonconvulsive status epilepticus may experience long periods of:

Nonconvulsive status epilepticus can also cause a person to fall into a coma.

A person has nonconvulsive status epilepticus if:

  1. They are unresponsive and unaware of what is going on around them.
  2. They have a seizure that lasts for longer than 10 minutes.

Seizures that last longer than 10 minutes are unlikely to stop without treatment. An individual should call 911 immediately if they think someone is experiencing nonconvulsive status epilepticus.

Learn more about what to do when someone is unconscious.

There are several different causes of status epilepticus. These include:

Status epilepticus is a medical emergency. It can be life threatening and cause a person to develop brain damage, which may be due to:

  • the original injury that caused the status epilepticus
  • stress on a person’s body due to multiple tonic-clonic seizures
  • injury as a result of repeated electrical discharges on the brain

Other possible complications of status epilepticus include:

If a person notices anyone experiencing symptoms of status epilepticus, they should call 911 immediately.

Healthcare professionals will begin treatment for status epilepticus as soon as possible. This may help reduce the adverse effects of the condition.

They may first treat status epilepticus by using benzodiazepines. If a person has received an epilepsy diagnosis, a doctor may also administer anti-epilepsy drugs.

A healthcare professional may also provide a person with additional oxygen and intravenous fluids.

If the anti-epilepsy drugs do not stop someone from seizing, the doctor may put them into a coma to stop the seizures from occurring.

During treatment, doctors can monitor a person’s brain activity using electroencephalography.

A healthcare professional may perform different tests to help determine the cause of a person’s status epilepticus. If it has occurred due to a medical condition, the patient may have a more negative outlook than those without any underlying medical conditions.

A person may help prevent developing status epilepticus in the following ways:

  • taking seizure medication as a doctor has prescribed, without missing doses
  • keeping track of potential seizure triggers
  • using any rescue therapies, such as benzodiazepines, only in emergencies and as a doctor advises

Status epilepticus is a potentially life threatening condition. It occurs when a person has a seizure that lasts for 5 minutes or more or when a person has multiple seizures without regaining consciousness in between them.

A person can develop status epilepticus with or without a history of epilepsy. It has numerous possible causes, such as CNS infection or hypertensive emergency.

A person should seek immediate medical attention for anyone showing signs of status epilepticus by calling 911. The sooner the individual receives treatment, the less likely they are to experience adverse effects, such as brain damage or death.