Who is at risk for prolonged seizures?
This article reviews how long seizures last and how frequently seizures are prolonged, risk factors for prolonged seizures, and a conceptual framework that links them. These data are derived from studies of patients with a first unprovoked seizure, studies of children with febrile seizures, studies of population-based and community-based cohorts with newly diagnosed epilepsy and patients with refractory epilepsy, and treatment trials. Prolonged seizures that exceed 5 to 10 minutes are relatively common, and the key factor in the identification of those at risk is a history of a prior prolonged seizure. A subgroup of patients with seizures is predisposed to prolonged although not necessarily frequent seizures, which are associated with increased morbidity, increased emergency department visits, and a decreased quality of life. This article also addresses criteria used to justify treatment of a seizure once it has continued longer than 5 minutes and the rationale for such treatment.
Shinnar
Shlomo
S
Comprehensive Epilepsy Management Center, Montefiore Medical Center, Albert Einstein College of Medicine, NY 10467, USA. sshinnar@montefiore.org
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D004827:Epilepsy / Q000503:physiopathology; D006801:Humans; D007223:Infant; D008875:Middle Aged; D012307:Risk Factors; D012640:Seizures / Q000503:physiopathology*; D013226:Status Epilepticus / Q000503:physiopathology*; D013997:Time Factors