Management Strategies for Pediatric Status Epilepticus

Background: Status epilepticus is a neurological emergency in children, defined by continuous seizure activity or recurrent seizures recurrent seizures without recovery. Its successful management requires a prompt, systematic, and staged therapeutic approach to prevent irreversible neurological injury. The choice and sequence of antiseizure medications (ASMs), particularly after first-line treatment fails, are critical to achieving rapid seizure termination. Methods: Here, we review current evidence and expert consensus from international guidelines on the pharmacologic management of pediatric status epilepticus. It examines the efficacy, safety, and practical considerations of treatment strategies across the emergent, urgent, and refractory phases of care. Results: A standardized, stepwise protocol is fundamental to effective treatment. The initial approach for emergency treatment involves administering Benzodiazepines. For refractory cases, second-line agents such as Fosphenytoin, Phenobarbital, Levetiracetam, and Valproic acid are central to urgent control therapy, with selection often influenced by patient-specific factors and institutional preference. The management of super-refractory status epilepticus necessitates intensive care support for the administration of continuous anesthetic infusions and even immunomodulators such as corticosteroids or Anakinra. Concurrently, a diligent search for and treatment of the underlying etiology is imperative for long-term management. Conclusion: The optimal treatment of pediatric status epilepticus involves the immediate application of a sequential pharmacologic protocol integrated with comprehensive supportive care. This approach maximizes the potential for rapid seizure cessation while minimizing complications. Ongoing research is essential to further refine agent selection and improve outcomes for this vulnerable population.

کلیدواژه ها:

Status Epilepticus ، Seizure ، Children ، Treatment