Skip to main content
SpringerLink
Log in

Generalized Convulsive Status Epilepticus

Causes, Clinical Manifestations, and Consequences

  • Chapter
Book cover Status Epilepticus

Part of the book series: Current Clinical Neurology ((CCNEU))

Abstract

Generalized convulsive status epilepticus (GCSE) is the most clinically dramatic and medically dangerous form of status epilepticus (SE). GCSE is characterized either by continuous bilateral convulsive activity or by generalized convulsive seizures that recur without significant recovery between them. Although GCSE can in fact begin with a single partial seizure or partial SE, and although the visible convulsive activity normally decreases in intensity and frequency with time, the cardinal feature of GCSE remains the widespread clonic movements of the extremities. In simplified classification schemes of SE, GCSE is usually contrasted with non-convulsive SE and with partial or focal SE (1,2).

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 169.00
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 219.00
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Celesia GG. Modern concepts of status epilepticus. JAMA 1976;235:1571–1574.

    Article  PubMed  CAS  Google Scholar 

  2. Treiman DM, Delgado-Escueta AV. Status epilepticus. In: Thompson RA, Green JR, eds. Critical Care of Neurological and Neurosurgical Emergencies. New York: Raven Press; 1980:53–99.

    Google Scholar 

  3. Hanhan UA, Fiallos MR, Orlowski JP. Status epilepticus. Pediatr Clin North Amer 2001;48:683–694.

    Article  CAS  Google Scholar 

  4. Fountain NB. Status epilepticus: risk factors and complications. Epilepsia. 2000;41(suppl 2):S23–30.

    Article  PubMed  Google Scholar 

  5. Hauser WA. Status epilepticus: epidemiologic considerations. Neurology 1990;40(suppl 2):9–13.

    PubMed  CAS  Google Scholar 

  6. Scholtes FB, Renier WO, Meinardi H. Generalized convulsive status epilepticus: Causes, therapy, and outcome in 346 patients. Epilepsia 1994;35:1104–1112.

    Article  PubMed  CAS  Google Scholar 

  7. DeLorenzo RJ, Hauser WA, Towne AR, Boggs JG, Pellock JM, Penberthy L, Garnett L, Fortner CA, Ko D. A prospective, population-based epidemiologic study of status epilepticus in Richmond, Virginia. Neurology 1996;46:1029–1035.

    PubMed  CAS  Google Scholar 

  8. Wheless JW. Acute management of seizures in the syndromes of idiopathic generalized epilepsies. Epilepsia 2003;44(suppl 2):22–26.

    Article  PubMed  CAS  Google Scholar 

  9. Celesia GG. Prognosis in convulsive status epilepticus. Adv Neurol 1983;34:55–59.

    PubMed  CAS  Google Scholar 

  10. Hauser WA. Status epilepticus: frequency, etiology, and neurological sequelae. In: Delgado-Escueta AV, Wasterlain CG, Treiman DM, Porter RJ, eds. Advances in Neurology: Status Epilepticus, vol. 34. New York: Raven Press; 1983:3–14

    Google Scholar 

  11. Rumbach L, Sablot D, Berger E, Tatu L, Vuillier F, Moulin T. Status epilepticus in stroke: Report on a hospital-based stroke cohort. Neurology 2000;54:350–354.

    Article  PubMed  CAS  Google Scholar 

  12. Afsar N, Kaya D, Aktan S, Sykut-Bingol C. Stroke and status epilepticus: stroke type, type of status epilepticus, and prognosis. Seizure 2003;12:23–27.

    Article  PubMed  Google Scholar 

  13. Velioglu SK, Ozmenoglu M, Boz C, Alioglu Z. Status epilepticus after stroke. Stroke 2001;32:1169–1172.

    PubMed  CAS  Google Scholar 

  14. Labovitz DL, Hauser WA, Sacco RL. Prevalence and predictors of early seizure and status epilepticus after first stroke. Neurology 2001;57:200–206.

    PubMed  CAS  Google Scholar 

  15. Temkin NR, Haglund MM, Winn HR. Post-traumatic seizures. In: Youmans JR, ed. Neurological Surgery, 4th ed. Philadelphia: W. B. Saunders; 1996:1834–1839.

    Google Scholar 

  16. Annegers JF, Hauser WA, Coan SP, Rocca WA. A population-based study of seizures after traumatic brain injuries. N Engl J Med 1998;338:20–24.

    Article  PubMed  CAS  Google Scholar 

  17. Chang BS, Lowenstein DH. Practice parameter: antiepileptic drug prophylaxis in severe traumatic brain injury. Neurology 2003;60:10–16.

    PubMed  Google Scholar 

  18. Temkin NR. Antiepileptogenesis and seizure prevention trials with antiepileptic drugs: meta-analysis of controlled trials. Epilepsia 2001;42:515–524.

    Article  PubMed  CAS  Google Scholar 

  19. Goldstein LB. Prescribing of potentially harmful drugs to patients admitted to hospital after head injury. J Neurol Neurosurg Psychiatry 1995;58:753–755.

    PubMed  CAS  Google Scholar 

  20. Moots PL, Maciunas RJ, Eisert DR, Parker RA, Laporte K, Abou-Khalil B. The course of seizure disorders in patients with malignant gliomas. Arch Neurol 1995;52:717–724.

    PubMed  CAS  Google Scholar 

  21. Wu YW, Shek DW, Garcia PA, Zhao S, Johnston SC. Incidence and mortality of generalized convulsive status epilepticus in California. Neurology 2002;58:1070–1076.

    PubMed  CAS  Google Scholar 

  22. DeLorenzo RJ, Pellock JM, Towne AR, Boggs JG. Epidemiology of status epilepticus. J Clin Neurophysiol 1995;12:316–325.

    PubMed  CAS  Google Scholar 

  23. Sokic DV, Stojsavljevic N, Drulovic J, Dujmovic I, Mesaros S, Ercegovac M, Peric V, Dragotinovic G, Levic Z. Seizures in multiple sclerosis. Epilepsia 2001;42:72–79.

    Article  PubMed  CAS  Google Scholar 

  24. Nyquist PA, Cascino GD, Rodriguez M. Seizures in patients with multiple sclerosis seen at Mayo Clinic, Rochester, Minn., 1990–1998. Mayo Clin Proc 2001;76:983–986.

    PubMed  CAS  Google Scholar 

  25. Delanty N, French JA, Labar DR, Pedley TA, Rowan AJ. Status epilepticus arising de novo in hospitalized patients: an analysis of 41 patients. Seizure 2001;10:116–119.

    PubMed  CAS  Google Scholar 

  26. Eleftheriadis N, Fourla E, Eleftheriadis D, Karlovasitou A. Status epilepticus as a manifestation of hepatic encephalopathy. Acta Neurol Scand 2003;107:142–144.

    Article  PubMed  CAS  Google Scholar 

  27. Alldredge BK, Lowenstein DH. Status epilepticus related to alcohol abuse. Epilepsia 1993;34:1033–1037.

    Article  PubMed  CAS  Google Scholar 

  28. Hillbom M, Pieninkeroinen I, Leone M. Seizures in alcohol-dependent patients: epidemiology, pathophysiology and management. CNS Drugs 2003;17:103–130.

    Article  Google Scholar 

  29. Treiman DM. Generalized convulsive status epilepticus in the adult. Epilepsia 1993;34(suppl 1):S2–11.

    PubMed  Google Scholar 

  30. Treiman DM. Electroclinical features of status epilepticus. J Clin Neurophysiol 1995;12:343–362.

    Article  PubMed  CAS  Google Scholar 

  31. Treiman DM, Walton NY, Kendrick C. A progressive sequence of electrographic changes during generalized convulsive status epilepticus. Epilepsy Res 1990;5:49–60.

    Article  PubMed  CAS  Google Scholar 

  32. Biton V, Gates JR, dePadua Sussman L. Prolonged postictal encephalopathy. Neurology 1990;40:963–966.

    PubMed  CAS  Google Scholar 

  33. Fagan KJ, Lee SI. Prolonged confusion following convulsions due to generalized nonconvulsive status epilepticus. Neurology 1990;40:1689–1694.

    PubMed  CAS  Google Scholar 

  34. Walton NY. Systemic effects of generalized convulsive status epilepticus. Epilepsia 1993;34(suppl 1):S54–58.

    PubMed  Google Scholar 

  35. Aminoff MJ, Simon RP. Status epilepticus: causes, clinical features and consequences in 98 patients. Am J Med 1980;69:657–666.

    Article  PubMed  CAS  Google Scholar 

  36. Meldrum BS, Vigouroux RA, Brierley JB. Systemic factors and epileptic brain damage: prolonged seizures in paralyzed artificially ventilated baboons. Arch Neurol 1973;29:82–67.

    PubMed  CAS  Google Scholar 

  37. Boggs JG, Painter JA, DeLorenzo RJ. Analysis of electrocardiographic changes in status epilepticus. Epilepsy Res 1993;14:87–94.

    Article  PubMed  CAS  Google Scholar 

  38. Meldrum BS, Brierley JB. Prolonged epileptic seizures in primates: ischemic cell change and its relation to ictal physiological events. Arch Neurol 1973;28:10–17.

    PubMed  CAS  Google Scholar 

  39. Rowan AJ, Scott DF. Major status epilepticus: a series of 42 patients. Acta Neurol Scand 1970;46:573–584.

    PubMed  CAS  Google Scholar 

  40. Oxbury JM, Whitty CWM. Causes and consequences of status epilepticus in adults: a study of 86 cases. Brain 1971;94:733–744.

    Article  PubMed  CAS  Google Scholar 

  41. Simon RP, Bayne LL, Tranbaugh RF, Lewis FR. Elevated pulmonary lymph flow and protein content during status epilepticus in sheep. J Appl Physiol 1982;52:91–95.

    PubMed  CAS  Google Scholar 

  42. Meldrum BS, Horton RW, Bloom SR, Butler J, Keenan J. Endocrine factors and glucose metabolism during seizures in baboons. Epilepsia 1979;20:527–534.

    PubMed  CAS  Google Scholar 

  43. Singhal PC, Chugh KS, Golati DR. Myoglobinuria and renal failure after status epilepticus. Neurology 1978;28:200–201.

    PubMed  CAS  Google Scholar 

  44. Sato T, Ota M, Matsuo M, Tasaki H, Miyazaki S. Recurrent reversible rhabdomyolysis associated with hyperthermia and status epilepticus. Acta Paediatr 1995;84:1083–1085.

    PubMed  CAS  Google Scholar 

  45. Barry E, Hauser WA. Status epilepticus: the interaction of epilepsy and acute brain disease. Neurology 1993;43:1473–1478.

    PubMed  CAS  Google Scholar 

  46. Logroscino G, Hesdorffer DC, Cascino GD, Annegers JF, Bagiella E, Hauser WA. Long-term mortality after a first episode of status epilepticus. Neurology 2002;58:537–541.

    PubMed  CAS  Google Scholar 

  47. DeLorenzo RJ, Towne AR, Pellock JM, Ko D. Status epilepticus in children, adults, and the elderly. Epilepsia 1992;33(suppl 4):15–25.

    Google Scholar 

  48. Maytal J, Shinnar S, Moshe SL, Alvarez LA. Low morbidity and mortality of status epilepticus in children. Pediatrics 1989;83:323–331.

    PubMed  CAS  Google Scholar 

  49. Lowenstein DH, Alldredge BK. Status epilepticus at an urban public hospital in the 1980’s. Neurology 1993;43:483–488.

    PubMed  CAS  Google Scholar 

  50. Towne AR, Pellock JM, Ko D, DeLorenzo, RJ. Determinants of mortality in status epilepticus. Epilepsia 1994;35:27–34.

    Article  PubMed  CAS  Google Scholar 

  51. Drislane FW, Blum AS, Lopez MR, Schomer DL. Duration of status epilepticus and survival: minimal effect beyond 10 hours. J Neurol 2002;249(suppl 1):178 (abstract).

    Google Scholar 

  52. Lothman EW, Bertram EH. Epileptogenic effects of status epilepticus. Epilepsia 1993;34(suppl 1):S59–70.

    PubMed  Google Scholar 

  53. Hesdorffer DC, Logroscino G, Cascino G, Annegers JF, Hauser WA. Risk of unprovoked seizure after acute symptomatic seizure: effect of status epilepticus. Ann Neurol 1998;44:908–912.

    Article  PubMed  CAS  Google Scholar 

  54. Aicardi J, Chevrie JJ. Consequences of status epilpeticus in infants and children. In: Delgado-Escueta AV, Wasterlain CG, Treiman DW, Porter RJ, eds. Status Epilepticus. New York: Raven Press; 1983:115–125.

    Google Scholar 

  55. Chang BS, Lowenstein DH. Mechanisms of disease: epilepsy. N Engl J Med 2003;349:1257–1266.

    Article  PubMed  Google Scholar 

  56. Dodrill CB, Wilensky AJ. Intellectual impairment as an outcome of status epilpeticus. Neurology 1990;40(suppl 2):23–27.

    PubMed  CAS  Google Scholar 

  57. Buck D, Baker GA, Jacoby A, Smith DF, Chadwick DW. Patients’ experiences of injury as a result of epilepsy. Epilepsia 1997;38:439–444.

    Article  PubMed  CAS  Google Scholar 

  58. Davidson DL, Macdonald S. The costs of trauma caused by seizures: can they be reduced? Seizure 2002;11:344–347.

    Article  PubMed  CAS  Google Scholar 

  59. McCullen GM, Brown CC. Seizure-induced thoracic burst fractures: a case report. Spine 1994;19:77–79.

    Article  PubMed  CAS  Google Scholar 

  60. DeToledo J, Haddad H, Ramsay RE. Surgical correction of scoliosis in patients with generalized seizures. Risk of vertebral body fracture. Spine 1998;23:1006–1008.

    Article  PubMed  CAS  Google Scholar 

  61. Winter RB, Kriel RL. Scoliosis due to epilepsia partialis continua. J Pediatr Orthop 1985;5:94–96.

    PubMed  CAS  Google Scholar 

  62. Spitz MC, Towbin JA, Shantz D, Adler LE. Risk factors for burns as a consequence of seizures in persons with epilepsy. Epilepsia 1994;35:764–767.

    Article  PubMed  CAS  Google Scholar 

  63. Celesia GG, Grigg MM, Ross E. Generalized status myoclonicus in acute anoxic and toxic-metabolic encephalopathies. Arch Neurol 1988;45:781–784.

    PubMed  CAS  Google Scholar 

  64. Young GB, Gilbert JJ, Zochodne DW. The significance of myoclonic status epilepticus in postanoxic coma. Neurology 1990;40:1843–1848.

    PubMed  CAS  Google Scholar 

  65. Berkovic SF, Andermann F, Carpenter S, Wolfe LS. Progressive myoclonus epilepsies: specific causes and diagnosis. N Engl J Med 1986;315:296–305.

    Article  PubMed  CAS  Google Scholar 

  66. Kimura S, Kobayashi T. Two patients with juvenile myoclonic epilepsy and nonconvulsive status epilepticus. Epilpesia 1996;37:275–279.

    Article  CAS  Google Scholar 

  67. Jumao-as A, Brenner RP. Myoclonic status epilepticus: a clinical and electroencephalographic study. Neurology 1990;40:1199–1202.

    PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Comprehensive Epilepsy Center, Department of Neurology, Beth Israel-Deaconess Medical Center, Harvard Medical School, Boston, MA

    Bernard S. Chang MD

Authors
  1. Bernard S. Chang MD
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Harvard Medical School, Comprehensive Epilepsy Program, Beth Israel Deaconess Medical Center, Boston, Massachusetts

    Frank W. Drislane MD (Associate Professor of Neurology) (Associate Professor of Neurology)

Rights and permissions

Reprints and permissions

Copyright information

© 2005 Humana Press Inc., Totowa, NJ

About this chapter

Cite this chapter

Chang, B.S. (2005). Generalized Convulsive Status Epilepticus. In: Drislane, F.W. (eds) Status Epilepticus. Current Clinical Neurology. Humana Press. https://doi.org/10.1385/1-59259-945-1:127

Download citation

  • DOI: https://doi.org/10.1385/1-59259-945-1:127

  • Publisher Name: Humana Press

  • Print ISBN: 978-1-58829-355-8

  • Online ISBN: 978-1-59259-945-5

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation