Convulsive status epilepticus (CSE) is often defined as a convulsion lasting at least 30 min or recurrent convulsions occurring over a 30-min period without recovery of consciousness between each convulsion. This review aims to discuss the relationships between CSE, aetiology, subsequent brain injury and adverse outcomes in childhood.

CSE is the most common childhood neurological emergency, with an estimated incidence of 18–20 per 100 000 children per year.1 This is much greater than the adult incidence of around 4–6 per 100 000 per year.1^–4 It occurs at similar rates in both boys and girls, incidence being highest in infancy and falling with increasing age. In a recent prospective, population-based study of CSE carried out wholly in childhood, The North London Status Epilepticus in Childhood Surveillance Study (NLSTEPSS), the incidence of CSE was shown to be greatest in children under 1 year of age (51 per 100 000 per year) compared with those aged 1–4 years (29 per 100 000 per year), 5–9 years (9 per 100 000 per year) and 10–15 years (2 per 100 000 per year).1

Adverse outcomes after CSE include death, cognitive impairment, permanent neurological deficits and subsequent epilepsy.5^–8 While it is widely accepted that CSE is associated with significant morbidity and mortality, there is controversy over the extent to which these adverse outcomes are the result of the CSE itself and how much they are influenced by factors such as the cause of the CSE, the child’s age or treatment of the seizure.

Two main populations of children have episodes of CSE: those who were previously neurologically healthy, with normal neurodevelopment, no neurological deficit and no history of epilepsy and those with neurological problems prior …