Treatment of paediatric status epilepticus

Status epilepticus (SE) is a relatively common occurrence in paediatric practice. The incidence is highest in the first year of life; the cause is often acute symptomatic. Different types of SE can be distinguished. Convulsive SE is a medical emergency which requires a timely and effective treatment. We present an already established step scheme for therapeutic escalation. Benzodiazepines are the drugs of first choice, followed by valproate, phenobarbital or phenytoin. If this is not successful, treatment with midazolam or thiopental one in an intensive care setting will be necessary. The same algorithm applies to focal SE. Absence status and generalized myoclonic SE are treated with benzodiazepines and valproate. Levetiracetam may be an additional option. Since the prognosis of SE is mainly determined by its cause, a timely aetiological diagnosis is also essential.