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Status epilepticus – adults and children

Neuro

For healthcare professionals. This information does not replace clinical judgement in the individual case; the current summary of product characteristics and the guidelines cited are authoritative.

Medically reviewed: Dr. med. univ. Daniel Pehböck, DESA, 01.11.2026

Status epilepticus – adults and children: Definition and timeline, Consider the cause at the same time, Step 1 – benzodiazepines (adults), Step 2 – after two benzodiazepine doses (adults), Step 3 – refractory status: anaesthesia, Children (beyond the neonatal period) – concise for emergency, anaesthesia and intensive care teams, with sources and medically reviewed.

What the chapter covers

  1. Definition and timeline
  2. Consider the cause at the same time
  3. Step 1 – benzodiazepines (adults)
  4. Step 2 – after two benzodiazepine doses (adults)
  5. Step 3 – refractory status: anaesthesia
  6. Children (beyond the neonatal period)

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Sources and guidelines

  1. Rosenow F, Weber J et al. S2k-Leitlinie Status epilepticus im Erwachsenenalter. Deutsche Gesellschaft für Neurologie gemeinsam mit der Österreichischen Gesellschaft für Neurologie (ÖGN), 2020; AWMF-Register 030-079, korrigierte Registerfassung 03/2022, gültig bis 29.06.2025.
  2. Trollmann R, Brandl U et al. (Gesellschaft für Neuropädiatrie). S1-Leitlinie Therapie des konvulsiven Status epilepticus im Kindes- und Jugendalter (jenseits der Neugeborenenperiode). AWMF-Register 022-019 (Fassung 2025; Recherche nennt auch Stand 01/2026.
  3. Resuscitation Council UK. Paediatric advanced life support algorithm.
  4. Djakow J, Turner NM, Skellett S et al. European Resuscitation Council Guidelines 2025 Paediatric Life Support. Resuscitation 2025;215 Suppl 1:110767.
  5. Jünemann et al. Prähospitale Behandlung von Anfallsclustern und Status epilepticus. Clin Epileptol 2025.
  6. Trinka E, Cock H, Hesdorffer D et al. A definition and classification of status epilepticus.
  7. Glauser T, Shinnar S, Gloss D et al. Evidence-based guideline: Treatment of convulsive status epilepticus in children and adults. Report of the Guideline Committee of the American Epilepsy Society. Epilepsy Curr 2016;16:48–61.
  8. Kapur J, Elm J, Chamberlain JM et al. Randomized trial of three anticonvulsant medications for status epilepticus (ESETT). N Engl J Med 2019;381:2103–2113.
  9. Silbergleit R, Durkalski V, Lowenstein D et al. Intramuscular versus intravenous therapy for prehospital status epilepticus (RAMPART). N Engl J Med 2012;366:591–600.
  10. National Institute for Health and Care Excellence (NICE). Epilepsies in children, young people and adults. NICE guideline NG217, 2022 (mit späteren Aktualisierungen)
  11. Neurocritical Care Society. Emergency Neurological Life Support (ENLS), Version 5.0.
  12. Lyttle MD et al. Levetiracetam versus phenytoin for second-line treatment of paediatric convulsive status epilepticus (EcLiPSE)
  13. Dalziel SR et al. Levetiracetam versus phenytoin for second-line treatment of convulsive status epilepticus in children (ConSEPT)
  14. Summaries of product characteristics of authorised products – product and section for each dose in the app.