Comparison of pediatric patients with status epilepticus lasting 5–29 min versus ≥ 30 min

The most common thresholds for considering prolonged seizures as status epilepticus (SE) are 5 and 30 min. It is unknown whether these different thresholds (5 or 30 min) identify patient populations with different electroclinical characteristics. We compared the characteristics of patients with SE lasting 5–29 min (SE_5–29) with those with SE lasting ≥ 30 min (SE_≥ 30). Inclusion criteria were the following: 1) 1 month to 21 years of age at the time of SE, 2) convulsive seizures, and 3) seizure duration ≥ 5 min. Exclusion criteria were the following: 1) exclusively neonatal seizures, 2) psychogenic nonepileptic seizures, or 3) incomplete information about seizure duration. Four hundred forty-five patients (50.1% male) with a median (p₂₅–p₇₅) age at SE of 5.5 (2.8–10.5) years were enrolled. Status epilepticus lasted for 5–29 min in 296 (66.5%) of subjects and for ≥ 30 min in 149 (33.5%). Patients with SE_≥ 30 were younger than the patients with SE_5–29 at the time of seizure onset (median: 1 versus 2.1 years, p = 0.0007). Status epilepticus as the first seizure presentation was more frequent in patients with SE_≥ 30 (24.2% versus 12.2%, p = 0.002). There was a tendency towards a higher rate of abnormalities in the magnetic resonance imaging at baseline in patients with SE_≥ 30 (70.5% versus 57.1%, p = 0.061). Differences were not detected in seizure frequency, seizure types, presence of developmental delay, and electroencephalogram abnormalities at baseline. In the pediatric population, SE thresholds of either 5 or 30 min identify groups of patients with very similar electroclinical characteristics, which may influence future definitions of pediatric SE.