Continuous status epilepticus is a convulsive seizure lasting more than 30 minutes, or multiple consecutive seizures in which consciousness does not return between seizures for more than 30 minutes. A continuous seizure is one in which convulsive seizures are frequent and more frequent, but interictal consciousness is restored and vital signs are normal. Epileptic electrical continuity is the presence of persistent epileptiform discharges on the EEG for more than 30 minutes, but without clinical seizures. Even with active resuscitation, the death rate is still 3.6%, and the survivors can also suffer from permanent neurological sequelae (such as brain atrophy, uncontrollable epilepsy, mental retardation, paralysis, etc.) due to convulsive brain injury. Persistent pediatric epilepsy occurs mostly within 1 year of age, and 60% occur within 5 years of age. Uncontrollable generalized convulsive status epilepticus can be fatal due to a variety of serious complications or the primary cause of the status epilepticus. Second, the pathophysiology During persistent epilepsy, the abnormal firing activity of brain cells increases the metabolic rate of the brain, and blood flow, oxygen consumption and glucose uptake are greatly increased. In the early stages of convulsions, compensatory changes such as increased heart rate, increased cardiac output, and increased blood pressure occur to increase cerebral blood perfusion, thereby maintaining abnormal firing and supplying energy for muscle twitching. Prolonged convulsive seizures lead to depletion of cerebral oxygen and glucose supply, cell and tissue failure, inadequate cerebral perfusion, severe metabolic acidosis, cardiac and hepatic dysfunction, cerebral edema, and increased intracranial pressure. The concomitant hyperthermia further aggravates the metabolic disorder and leads to neuronal necrosis. Especially the hippocampus and cerebral cortex are the most sensitive. About 26% of children have acute central system injury or metabolic disorders, 21% have chronic convulsive disease or non-progressive encephalopathy, and sudden discontinuation of antiepileptic drugs or fever are the most common contributing factors. The diagnosis of convulsive status epilepticus is generally not difficult and can be clearly diagnosed according to the duration of convulsive seizures. The main points of diagnosis are as follows: 1. Before a grand mal seizure, there are often aura of sensory dullness, limb tremors, palpitations, sweating, delusions, hallucinations, etc. 2. 2. There may be clinical manifestations of convulsive seizures. 3, grand mal seizures have frequent seizures in a short period of time, and after each seizure there is a recovery of consciousness or a seizure lasts for more than 30 minutes is called persistent status epilepticus. 4, Some patients may have profuse sweating and high fever. 5. Severe patients may suffer from brain herniation and respiratory and circulatory dysfunction due to cerebral edema. Physical and chemical examinations 1. Blood tests: routine blood, liver and kidney function, electrolytes, blood glucose, blood gas analysis, blood culture, antiepileptic drug blood concentration, amino acid analysis, etc. Generally, in the process of emergency treatment, the first step is to obtain evidence about electrolyte, acid-base and sugar metabolism disorders. 2, urine and stool examination: urine and stool routine, urine sugar, ketone bodies, iron trichloride, urinary bilirubin, urinary choline determination, urinary amino acid screening, etc. 3, cerebrospinal fluid examination: cerebrospinal fluid examination should be performed as soon as possible after the convulsions are controlled, and if there are signs of cranial hypertension, lumbar puncture should be performed after lowering the cranial pressure. The examination of cerebrospinal fluid should include pressure measurement, routine, biochemical, and bacterial culture, bacterial or viral antibody determination according to the condition, and molecular biology examination about pathogenesis if available. 4, EEG: EEG examination helps in the diagnosis and typing of epilepsy. MRL can show the nature of tumor and blood vessels in the posterior cranial fossa. 6. Other: chromosomal examination, IQ determination, determination of specific enzyme activities for genetic metabolic diseases, etc. The tests to be done to confirm the diagnosis of persistent pediatric epilepsy cannot be ignored, which can help a lot in whether the child is epileptic, and the treatment after the diagnosis. Six, treatment For persistent status epilepticus, especially convulsive persistent status should be resuscitated in every second to terminate the clinical seizures as soon as possible, otherwise it is easy to cause serious brain damage. 1, general treatment: including keeping quiet, avoiding stimulation, ensuring a clear airway, oxygen, monitoring blood pressure, pulse (if necessary, give cardiac drugs), etc. 2, the choice of fast and powerful anticonvulsant drugs to control seizures: generally clinical convulsions lasting more than 5 minutes, that is, to give intravenous anti-convulsant drugs, for intravenous injection difficulties, rectal instillation of diazepam or intramuscular injection of paraldehyde and other ways. 3.Maintain vital functions, prevent and control complications, special attention should be paid to deal with cerebral edema, brain hernia formation, acidosis, respiratory and circulatory failure and hyperthermia, etc. 4, symptomatic treatment, including active cooling, prevention and control of cerebral edema (mannitol, furosemide and adrenal glucocorticoids can be used to control cerebral edema if the intracranial pressure is increased), ensure the stability of the internal environment (replenish body fluids, first give glucose solution, later appropriate supplementation of salt-containing liquid), anti-infection, etc. 5. Actively search for the causes and triggers and give the best possible intervention. 6.Long-term antiepileptic treatment should be given after the seizures have stopped.