Status epilepticus

Le référentiel médical TREKK est une collection des meilleures ressources et évidences sur divers sujets. La collection est constituée par une équipe de synthèse des connaissances à l’Alberta Research Centre for Health Evidence (ARCHE) et par une équipe de spécialistes qui contribuent au contenu médical TREKK.

L’équipe de synthèse utilise un cadre hiérarchique des données probantes en forme de pyramide « 4S » (voir le modèle “4S” Hierarchy of evidence), pour répondre aux besoins des parties prenantes. Pour ce faire, l’équipe effectue à priori une recherche de la littérature à partir des bases de données scientifiques (Cochrane Library, PubMed, TRIP Database) et des moteurs de recherche internet (Google, Google Scholar). Les résultats sont organisés en 5 volets de présentation :

1. Recommandations de base
2. Lignes directrices sur la pratique clinique et algorithmes
3. Survols et résumés des revues systématiques
4. Revues systématiques
5. Études clés

Ressources pour parents et familles, si applicable

En collaboration avec l’équipe de synthèse des connaissances, les spécialistes qui contribuent au contenu TREKK sélectionnent les items pertinents, présentés ci-dessous. Le référentiel médical TREKK n’est pas conçu comme liste exhaustive du sujet, mais plutôt comme liste sélectionnée par un consensus d’experts : c’est une liste de ressources fondées sur des données probantes à date, pertinentes, et utilisables au Service général des urgences médicales. Les ressources à libre accès sont privilégiées (c’est-à-dire, disponibles à tous, gratuites, et sans abonnement nécessaire).

Pour en savoir plus sur l’élaboration de nos référentiels, cliquez ici.

Un grand merci aux spécialistes cliniques et à l’Équipe de synthèse des connaissances qui ont dirigé le développement de ce référentiel médical.

Sarah Buttle, BScH, MD; Resident Doctor, Pediatric Neurology, Children’s Hospital of Eastern Ontario

Katherine Muir, MD, FRCPC; Program Director, Pediatric Neurology Residency Training Program; Assistant Professor, Department of Pediatrics, Children’s Hospital of Eastern Ontario

Dubravka A. Diksic, MDCM, FRCPC; Pediatric Emergency Physician, Assistant Professor, Department of Pediatrics, Pediatric  Emergency Medicine, Montreal Children’s Hospital

Liza Bialy, BSc, MPH, Knowledge Synthesis Project Coordinator, Alberta Research Centre for Health Evidence, Department of  Pediatrics, University of Alberta

Sarah Elliott, PhD, Assistant Director, Alberta Research Centre for Health Evidence, Department of Pediatrics, University of Alberta

Cliquez ici pour voir les ressources TREKK élaborées pour professionnels de la santé, parents, et familles.

1. National Institute for Health and Care Excellence. Epilepsies in children, young people and adults. 2022.
2. McKenzie KC, Hahn CD, Friedman JN. Emergency management of the paediatric patient with convulsive status epilepticus. Paediatr Child Health. 2021 Jan 21;26(1):50-66.
3. Silverman EC, Sporer KA, Lemieux JM, et al. Prehospital care for the adult and pediatric seizure patient: Current evidence-based recommendations. West J Emerg Med. 2017;18(3):419-36.
4. Glauser T, Shinnar S, Gloss D, et al. Evidence-based guideline: Treatment of convulsive status epilepticus in children and adults: Report of the guideline committee of the American epilepsy society. Epilepsy Curr. 2016;16(1):48-61.
5. Shah MI, Macias CG, Dayan PS, et al. An evidence-based guideline for pediatric prehospital seizure management using grade methodology. Prehosp Emerg Care. 2014;18 Suppl 1:15-24.
6. Mishra D, Sharma S, Sankhyan N, et al. Consensus guidelines on management of childhood convulsive status epilepticus. Indian Pediatr. 2014;51(12):975-90.
7. Abend NS, Loddenkemper T. Management of pediatric status epilepticus. Curr Treat Options Neurol. 2014;16(7):301.
8. Brophy GM, Bell R, Claassen J, et al. Guidelines for the evaluation and management of status epilepticus. Neurocrit Care. 2012;17(1):3-23.
9. Friedman J. Emergency management of the paediatric patient with generalized convulsive status epilepticus. Paediatr Child Health. 2011;16(2):91-104.
10. Kälviäinen R. Status epilepticus treatment guidelines. Epilepsia. 2007;48 Suppl 8:99-102.
11. Appleton R, Choonara I, Martland T, et al. The treatment of convulsive status epilepticus in children. The status epilepticus working party, members of the status epilepticus working party. Arch Dis Child. 2000;83(5):415-9.

1. Ferretti A, Riva A, Fabrizio A, et al. Best practices for the management of febrile seizures in children. Ital J Pediatr. 2024;50(1):95.
2. Singh A, Stredny CM, Loddenkemper T. Pharmacotherapy for pediatric convulsive status epilepticus. CNS Drugs. 2020;34(1):47-63.
3. Stahl-Timmins W. Managing febrile seizures. BMJ. 2015.
4. Patel N, Ram D, Swiderska N, et al. Clinical review: Febrile seizures. BMJ. 2015.
5. Hampers LC, Spina LA. Evaluation and management of pediatric febrile seizures in the emergency department. Emerg Med Clin North Am. 2011;29(1):83-93.

1. Corsello A, Marangoni MB, Macchi M, et al. Febrile seizures: A systematic review of different guidelines. Pediatr Neurol. 2024;155:141-8.
2. Zhang Q, Peng S, Wei Z, et al. Comparative efficacy and safety of second-line medications for status epilepticus: A network meta-analysis. Medicine (Baltimore). 2024;103(46):e40333.
3. Specchio N, Auvin S, Strzelczyk A, et al. Efficacy and safety of stiripentol in the prevention and cessation of status epilepticus: A systematic review. Epilepsia Open. 2024;9(6):2017-36.
4. Au YK, Kananeh MF, Rahangdale R, et al. Treatment of refractory status epilepticus with continuous intravenous anesthetic drugs: A systematic review. JAMA Neurol. 2024;81(5):534-48.
5. Cao Y, Li H, Chen M, et al. Evaluation and systematic review of guidance documents for status epilepticus. Epilepsy Behav. 2024;150:109555.
6. Chiriboga N, Spentzas T, Abu-Sawwa R. A systematic review and meta-analysis of ketamine in pediatric status epilepticus. Epilepsia. 2024;65(8):2200-12.
7. Aldharman SS, Alayed FT, Almutairi FA, et al. Intramuscular versus intravenous treatment of status epilepticus: A systematic review. Cureus. 2023;15(4):e38212.
8. Jain P, Aneja S, Cunningham J, et al. Treatment of benzodiazepine-resistant status epilepticus: Systematic review and network meta-analyses. Seizure. 2022;102:74-82.
9. Hashimoto R, Suto M, Tsuji M, et al. Use of antipyretics for preventing febrile seizure recurrence in children: A systematic review and meta-analysis. Eur J Pediatr. 2021;180(4):987-97.
10. Vossler DG, Bainbridge JL, Boggs JG, et al. Treatment of refractory convulsive status epilepticus: A comprehensive review by the American Epilepsy Society treatments committee. Epilepsy Curr. 2020;20(5):245-64.
11. McTague A, Martland T, Appleton R. Drug management for acute tonic‐clonic convulsions including convulsive status epilepticus in children. Cochrane Database of Systematic Reviews. 2018(1).
12. Poblete R, Sung G. Status epilepticus and beyond: A clinical review of status epilepticus and an update on current management strategies in super-refractory status epilepticus. Korean J Crit Care Med. 2017;32(2):89-105.
13. Whelan H, Harmelink M, Chou E, et al. Complex febrile seizures-a systematic review. Dis Mon. 2017;63(1):5-23.
14. Au CC, Branco RG, Tasker RC. Management protocols for status epilepticus in the pediatric emergency room: Systematic review article. J Pediatr (Rio J). 2017;93 Suppl 1:84-94.
15. Paul SP, Rogers E, Wilkinson R, Paul B. Management of febrile convulsion in children. Emerg Nurse. 2015;23(2):18-25.
16. Kimia AA, Bachur RG, Torres A, Harper MB. Febrile seizures: Emergency medicine perspective. Curr Opin Pediatr. 2015;27(3):292-7.
17. Prasad M, Krishnan PR, Sequeira R, Al‐Roomi K. Anticonvulsant therapy for status epilepticus. Cochrane Database of Systematic Reviews. 2014(9).
18. Najaf-Zadeh A, Dubos F, Hue V, et al. Risk of bacterial meningitis in young children with a first seizure in the context of fever: A systematic review and meta-analysis. PLoS One. 2013;8(1):e55270.
19. Riviello JJ, Jr., Ashwal S, Hirtz D, et al. Practice parameter: Diagnostic assessment of the child with status epilepticus (an evidence-based review): Report of the quality standards subcommittee of the American academy of neurology and the practice committee of the child neurology society. Neurology. 2006;67(9):1542-50.

1. Shah MI, Ostermayer DG, Browne LR, et al. Multicenter evaluation of prehospital seizure management in children. Prehosp Emerg Care. 2021;25(4):475-86.
2. Zeidan S, Rohaut B, Outin H, et al. Not all patients with convulsive status epilepticus intubated in pre-hospital settings meet the criteria for refractory status epilepticus. Seizure. 2021;88:29-35.
3. Kim D, Kim JM, Cho YW, et al. Antiepileptic drug therapy for status epilepticus. J Clin Neurol. 2021;17(1):11-9.
4. Vespa PM, Olson DM, John S, et al. Evaluating the clinical impact of rapid response electroencephalography: The decide multicenter prospective observational clinical study. Crit Care Med. 2020;48(9):1249-57.
5. Vasquez A, Gaínza-Lein M, Abend NS, et al. First-line medication dosing in pediatric refractory status epilepticus. Neurology. 2020;95(19):e2683-e96.
6. Lee SK. Diagnosis and treatment of status epilepticus. J Epilepsy Res. 2020;10(2):45-54.
7. Handral A, Veerappa BG, Gowda VK, et al. Levetiracetam versus fosphenytoin in pediatric convulsive status epilepticus: A randomized controlled trial. J Pediatr Neurosci. 2020;15(3):252-6.
8. Guterman EL, Sanford JK, Betjemann JP, et al. Prehospital midazolam use and outcomes among patients with out-of-hospital status epilepticus. Neurology. 2020;95(24):e3203-e12.
9. Chamberlain JM, Kapur J, Shinnar S, et al. Efficacy of levetiracetam, fosphenytoin, and valproate for established status epilepticus by age group: A double-blind, responsive-adaptive, randomised controlled trial. Lancet. 2020;395(10231):1217-24.
10. Appleton RE, Rainford NE, Gamble C, et al. Levetiracetam as an alternative to phenytoin for second-line emergency treatment of children with convulsive status epilepticus: The eclipse RCT. Health Technol Assess. 2020;24(58):1-96.
11. Amorim E, McGraw CM, Westover MB. A theoretical paradigm for evaluating risk-benefit of status epilepticus treatment. J Clin Neurophysiol. 2020;37(5):385-92.
12. Yazbeck M, Sra P, Parvizi J. Rapid response electroencephalography for urgent evaluation of patients in community hospital intensive care practice. J Neurosci Nurs. 2019;51(6):308-12.
13. Lyttle MD, Rainford NEA, Gamble C, et al. Levetiracetam versus phenytoin for second-line treatment of paediatric convulsive status epilepticus (eclipse): A multicentre, open-label, randomised trial. Lancet. 2019;393(10186):2125-34.
14. Kapur J, Elm J, Chamberlain JM, et al. Randomized trial of three anticonvulsant medications for status epilepticus. N Engl J Med. 2019;381(22):2103-13.
15. Dalziel SR, Borland ML, Furyk J, et al. Levetiracetam versus phenytoin for second-line treatment of convulsive status epilepticus in children (consept): An open-label, multicentre, randomised controlled trial. Lancet. 2019;393(10186):2135-45.
16. Carey JM, Studnek JR, Browne LR, et al. Paramedic-identified enablers of and barriers to pediatric seizure management: A multicenter, qualitative study. Prehosp Emerg Care. 2019;23(6):870-81.
17. Vasquez A, Gaínza-Lein M, Sánchez Fernández I, et al. Hospital emergency treatment of convulsive status epilepticus: Comparison of pathways from ten pediatric research centers. Pediatr Neurol. 2018;86:33-41.
18. Marino MC, Ostermayer DG, Mondragon JA, et al. Improving prehospital protocol adherence using bundled educational interventions. Prehosp Emerg Care. 2018;22(3):361-9.
19. 19. Marawar R, Basha M, Mahulikar A, et al. Updates in refractory status epilepticus. Crit Care Res Pract.  2018;2018:9768949.
20. Gaínza-Lein M, Sánchez Fernández I, Jackson M, et al. Association of time to treatment with shortterm outcomes for  pediatric patients with refractory convulsive status epilepticus. JAMA Neurol. 2018;75(4):410-8.
21. Verrotti A, Ambrosi M, Pavone P, Striano P. Pediatric status epilepticus: Improved management with new drug therapies?  Expert Opin Pharmacother. 2017;18(8):789-98.
22. Remick K, Redgate C, Ostermayer D, et al. Prehospital glucose testing for children with seizures: A proposed change in  management. Prehosp Emerg Care. 2017;21(2):216-21.
23. Hoyle JD, Jr., Crowe RP, Bentley MA, et al. Pediatric prehospital medication dosing errors: A national survey of  paramedics. Prehosp Emerg Care. 2017;21(2):185-91.
24. Smith DM, McGinnis EL, Walleigh DJ, Abend NS. Management of status epilepticus in children. J Clin Med. 2016;5(4).
25. Shah MI, Carey JM, Rapp SE, et al. Impact of high-fidelity pediatric simulation on paramedic seizure management. Prehosp Emerg Care. 2016;20(4):499-507.
26. İşgüder R, Güzel O, Ceylan G, et al. A comparison of intravenous levetiracetam and valproate for the treatment of refractory status epilepticus in children. J Child Neurol. 2016;31(9):1120-6.
27. Welch RD, Nicholas K, Durkalski-Mauldin VL, et al. Intramuscular midazolam versus intravenous lorazepam for the  prehospital treatment of status epilepticus in the pediatric population. Epilepsia. 2015;56(2):254-62.
28. Trinka E, Cock H, Hesdorffer D, et al. A definition and classification of status epilepticus–report of the ilae task force on  classification of status epilepticus. Epilepsia. 2015;56(10):1515-23.
29. Mundlamuri RC, Sinha S, Subbakrishna DK, et al. Management of generalised convulsive status epilepticus (se): A  prospective randomised controlled study of combined treatment with intravenous lorazepam with either phenytoin, sodium valproate or levetiracetam–pilot study. Epilepsy Res. 2015;114:52-8.
30. Momen AA, Azizi Malamiri R, Nikkhah A, et al. Efficacy and safety of intramuscular midazolam versus rectal diazepam in controlling status epilepticus in children. Eur J Paediatr Neurol. 2015;19(2):149-54.
31. Khongkhatithum C, Thampratankul L, Wiwattanadittakul N, Visudtibhan A. Intravenous levetiracetam in thai children and adolescents with status epilepticus and acute repetitive seizures. Eur J Paediatr Neurol. 2015;19(4):429-34.
32. Kämppi L, Mustonen H, Soinila S. Factors related to delays in pre-hospital management of status epilepticus. Neurocrit Care. 2015;22(1):93-104.
33. Harini C, Nagarajan E, Kimia AA, et al. Utility of initial EEG in first complex febrile seizure. Epilepsy Behav. 2015;52(Pt A):200-4.
34. Alford EL, Wheless JW, Phelps SJ. Treatment of generalized convulsive status epilepticus in pediatric patients. J Pediatr Pharmacol Ther. 2015;20(4):260-89.
35. Seinfeld S, Shinnar S, Sun S, et al. Emergency management of febrile status epilepticus: Results of the FEBSTAT study. Epilepsia. 2014;55(3):388-95.
36. Kim JS, Lee JH, Ryu HW, et al. Effectiveness of intravenous levetiracetam as an adjunctive treatment in pediatric refractory status epilepticus. Pediatr Emerg Care. 2014;30(8):525-8.
37. Chamberlain JM, Okada P, Holsti M, et al. Lorazepam vs diazepam for pediatric status epilepticus: A randomized clinical trial. JAMA. 2014;311(16):1652-60.
38. Thakker A, Shanbag P. A randomized controlled trial of intranasal-midazolam versus intravenous- diazepam for acute childhood seizures. J Neurol. 2013;260(2):470-4.
39. Silbergleit R, Lowenstein D, Durkalski V, Conwit R. Lessons from the rampart study–and which is the best route of administration of benzodiazepines in status epilepticus. Epilepsia. 2013;54 Suppl 6(0 6):74-7.
40. Silbergleit R, Durkalski V, Lowenstein D, et al. Intramuscular versus intravenous therapy for prehospital status epilepticus. N Engl J Med. 2012;366(7):591-600.
41. Nordli DR, Jr., Moshé SL, Shinnar S, et al. Acute EEG findings in children with febrile status epilepticus: Results of the FEBSTAT study. Neurology. 2012;79(22):2180-6.
42. Misra UK, Kalita J, Maurya PK. Levetiracetam versus lorazepam in status epilepticus: A randomized, open labeled pilot study. J Neurol. 2012;259(4):645-8.
43. McTague A, Kneen R, Kumar R, et al. Intravenous levetiracetam in acute repetitive seizures and status epilepticus in children: Experience from a children’s hospital. Seizure. 2012;21(7):529-34.
44. Malamiri RA, Ghaempanah M, Khosroshahi N, et al. Efficacy and safety of intravenous sodium valproate versus phenobarbital in controlling convulsive status epilepticus and acute prolonged convulsive seizures in children: A randomised trial. Eur J Paediatr Neurol. 2012;16(5):536-41.
45. Javadzadeh M, Sheibani K, Hashemieh M, Saneifard H. Intranasal midazolam compared with intravenous diazepam in patients suffering from acute seizure: A randomized clinical trial. Iran J Pediatr. 2012;22(1):1-8.
46. Silbergleit R, Lowenstein D, Durkalski V, Conwit R. Rampart (rapid anticonvulsant medication prior to arrival trial): A double-blind randomized clinical trial of the efficacy of intramuscular midazolam versus intravenous lorazepam in the prehospital treatment of status epilepticus by paramedics. Epilepsia. 2011;52 Suppl 8(Suppl 8):45-7.
47. Shearer P, Riviello J. Generalized convulsive status epilepticus in adults and children: Treatment guidelines and protocols. Emerg Med Clin North Am. 2011;29(1):51-64.
48. Arya R, Gulati S, Kabra M, et al. Intranasal versus intravenous lorazepam for control of acute seizures in children: A randomized open-label study. Epilepsia. 2011;52(4):788-93.
49. Sreenath TG, Gupta P, Sharma KK, Krishnamurthy S. Lorazepam versus diazepam-phenytoin combination in the treatment of convulsive status epilepticus in children: A randomized controlled trial. Eur J Paediatr Neurol. 2010;14(2):162-8.
50. Lewena S, Pennington V, Acworth J, et al. Emergency management of pediatric convulsive status epilepticus: A multicenter study of 542 patients. Pediatr Emerg Care. 2009;25(2):83-7.
51. Mpimbaza A, Ndeezi G, Staedke S, et al. Comparison of buccal midazolam with rectal diazepam in the treatment of prolonged seizures in Ugandan children: A randomized clinical trial. Pediatrics. 2008;121(1):e58-64.
52. Chin RF, Neville BG, Peckham C, et al. Treatment of community-onset, childhood convulsive status epilepticus: A prospective, population-based study. Lancet Neurol. 2008;7(8):696-703.
53. Mehta V, Singhi P, Singhi S. Intravenous sodium valproate versus diazepam infusion for the control of refractory status epilepticus in children: A randomized controlled trial. J Child Neurol. 2007;22(10):1191-7.
54. Agarwal P, Kumar N, Chandra R, et al. Randomized study of intravenous valproate and phenytoin in status epilepticus. Seizure. 2007;16(6):527-32.
55. Teng D, Dayan P, Tyler S, et al. Risk of intracranial pathologic conditions requiring emergency intervention after a first complex febrile seizure episode among children. Pediatrics. 2006;117(2):304-8.
56. Tay SK, Hirsch LJ, Leary L, et al. Nonconvulsive status epilepticus in children: Clinical and EEG characteristics. Epilepsia. 2006;47(9):1504-9.
57. Misra UK, Kalita J, Patel R. Sodium valproate vs phenytoin in status epilepticus: A pilot study. Neurology. 2006;67(2):340-2.
58. Shah I, Deshmukh CT. Intramuscular midazolam vs intravenous diazepam for acute seizures. Indian J Pediatr. 2005;72(8):667-70.
59. McIntyre J, Robertson S, Norris E, et al. Safety and efficacy of buccal midazolam versus rectal diazepam for emergency treatment of seizures in children: A randomised controlled trial. Lancet. 2005;366(9481):205-10.
60. Chin RF, Neville BG, Scott RC. Meningitis is a common cause of convulsive status epilepticus with fever. Arch Dis Child. 2005;90(1):66-9.
61. Mahmoudian T, Zadeh MM. Comparison of intranasal midazolam with intravenous diazepam for treating acute seizures in children. Epilepsy Behav. 2004;5(2):253-5.
62. Yu KT, Mills S, Thompson N, Cunanan C. Safety and efficacy of intravenous valproate in pediatric status epilepticus and acute repetitive seizures. Epilepsia. 2003;44(5):724-6.
63. Fişgin T, Gurer Y, Teziç T, et al. Effects of intranasal midazolam and rectal diazepam on acute convulsions in children: Prospective randomized study. J Child Neurol. 2002;17(2):123-6.
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