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ER Management of Status Epilepticus in Children

Prompt and effective management of status epilepticus in children is critical to prevent neurological complications and long-term sequelae. Initial management involves ensuring the child's safety and stabilizing vital signs, followed by rapid administration of antiepileptic medications. Benzodiazepines such as lorazepam or midazolam are first-line agents for terminating seizures and preventing progression to status epilepticus. If seizures persist, second-line agents such as phenytoin, fosphenytoin, or levetiracetam may be administered intravenously to achieve seizure control. In refractory cases, continuous infusions of anesthetic agents such as midazolam or propofol may be initiated in the intensive care unit. Timely neuroimaging studies may be indicated to rule out structural abnormalities or identify potential reversible causes of status epilepticus.

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Dr. Col Om Prakash Singh Profile Image

Dr. Col Om Prakash Singh

Professor & HOD Pediatrics Narayana Medical College, Patna

Dr. Om Prakash Singh is currently working as Professor & HOD Pediatrics in Narayana Medical College,Patna. He has 21 years of experience and 10+ yrs as Professor in Pediatrics. He has 27 publications across India. He is a life member of Indian Pediatric Association (IAP) & National Neonatal Forum ( NNF). 

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Dr. Col Om Prakash Singh
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Prompt and effective management of status epilepticus in children is critical to prevent neurological complications and long-term sequelae. Initial management involves ensuring the child's safety and stabilizing vital signs, followed by rapid administration of antiepileptic medications. Benzodiazepines such as lorazepam or midazolam are first-line agents for terminating seizures and preventing progression to status epilepticus. If seizures persist, second-line agents such as phenytoin, fosphenytoin, or levetiracetam may be administered intravenously to achieve seizure control. In refractory cases, continuous infusions of anesthetic agents such as midazolam or propofol may be initiated in the intensive care unit. Timely neuroimaging studies may be indicated to rule out structural abnormalities or identify potential reversible causes of status epilepticus.