Permanent neuronal injury can ensue within how many minutes of continuous seizure activity, even in the absence of apparent convulsions?

• A. 5-10
• B. 90-120
• C. 30-60
• D. 180-240

Answer: (C)

Prolonged seizure activity damages the brain because of an excitotoxic cascade: ongoing electrical firing causes massive glutamate release, overloading neurons with calcium, which triggers enzymes and free radicals that break down cellular structures and impair energy production. This injury can continue even when outward convulsions stop, a situation known as nonconvulsive status epilepticus. The window during which permanent neuronal injury is most likely to occur is about 30–60 minutes of continuous seizure activity. If seizures are stopped within this period, recovery is more likely; if they persist longer, the risk of irreversible damage increases. This is why rapid treatment is essential as soon as a seizure becomes prolonged, and why EEG monitoring matters when there are no obvious convulsions.