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J Child Neurol. 2007 May;22(5 Suppl):14S-20S.

Who is at risk for prolonged seizures?

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  • 1Comprehensive Epilepsy Management Center, Montefiore Medical Center, Albert Einstein College of Medicine, NY 10467, USA.


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.

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