Convulsive and nonconvulsive status epilepticus in children.

Status epilepticus (SE) is a common pediatric neurologic emergency that requires rapid assessment and management. Treatment of pediatric SE involves two equally important factors. First, rapid identification of the underlying etiology is essential, as decisions on how to treat and prognosticate depend on the cause of SE. Second, the timing of treatment initiation with adequate doses is crucial, as early action is most effective in terminating SE and decreasing morbidity and mortality. Currently, early treatment with adequate doses of a benzodiazepine is appropriate, followed by treatment with phenytoin, phenobarbital, or valproic acid. If the seizure does not stop or repetitive seizures continue, the addition of other medications (eg, levetiracetam) or pharmacologic coma induction may be indicated. This review evaluates treatment protocols for acute SE, prolonged SE, and nonconvulsive SE, including some management strategies that use newer anticonvulsants.