TY - JOUR T1 - Review of the new APLS guideline (2022): Management of the convulsing child JF - Archives of disease in childhood - Education & practice edition JO - Arch Dis Child Educ Pract Ed SP - 43 LP - 48 DO - 10.1136/archdischild-2021-323351 VL - 108 IS - 1 AU - Melody Bacon AU - Richard Appleton AU - Harish Bangalore AU - Celia Brand AU - Juliet Browning AU - Richard FM Chin AU - Satvinder Mahal AU - Susana Saranga Estevan AU - Kirsten McHale AU - Ailsa McLellan AU - Nicola Milne AU - Suresh Pujar AU - Tekki Rao AU - Steven Short AU - Stephen Warriner AU - Michael Yoong Y1 - 2023/02/01 UR - http://ep.bmj.com/content/108/1/43.abstract N2 - Convulsive status epilepticus (CSE) (box 1) is the most common childhood medical neurological emergency, with an incidence of approximately 20 per 100 000 per year in the developed world.1 2 Box 1 Definition of status epilepticusStatus epilepticus is a condition resulting either from failure of the mechanism responsible for seizure termination or from the initiation of mechanisms, which lead to abnormally prolonged seizures (after time point t1 at 5 min).It is a condition, which can have long-term consequences (after time point t2 after 30 min) including neuronal death, neuronal injury and alteration of neuronal networks, depending on the type and duration of seizures.CSE can be fatal, but mortality is lower in children than in adults—at about 2%–7%.3 Adverse neurological consequences following CSE consist of subsequent epilepsy, motor deficits, and learning and behavioural difficulties. The main determinant of outcome is the underlying aetiology (box 2). There is low risk of morbidity and mortality in children with unprovoked/prolonged febrile CSE. This risk increases significantly in cases with structural or genetic causes.Box 2 Common causes of status epilepticus Known (ie, symptomatic) Structural: Intracranial tumour, cerebrovasculardisease, head injury, cortical dysplasia Infectious: CNS infection (meningitis, encephalitis), tuberculosis, cerebral malaria Metabolic: Metabolic disturbance (electrolyte imbalance, glucose imbalance, organ failure, etc), metabolic disorders, anoxic injury, mitochondrial disorders Toxicity or drug-related: Low or high level of antiseizure medication, withdrawal of antiseizure medication, other drug/alcohol overdose, neurotoxins and poisons Inflammatory: Autoimmune disorders, neurocutaneous disorders Genetic: Dravet syndrome, ring chromosome 20, Angelman syndrome, fragile X syndrome, Rett syndrome, trisomy 21 Unknown (ie, cryptogenic) The Advanced Life Support Group (ALSG) who run the Advanced Paediatric Life Support (APLS) programme provides internationally renowned guidance on the emergency management of common childhood emergencies. The APLS programme is also endorsed by the Royal College of Paediatrics and Child Health. Together, a professional … ER -