Status epilepticus (SE) is one of the most commonly occurring neurologic emergencies. About 40% of SE cases occur in people with epilepsy. Convulsive SE is easily recognized, but nonconvulsive SE is not and requires both a high index of suspicion and EEG confirmation. SE has a high mortality risk and requires rapid effective treatment for optimal response to therapy and outcome. The goal of treatment is to stop all clinical and electrographic seizures while maintaining vital functions. If seizures continue after initial treatment with a benzodiazepine, additional antiepileptic therapy should be administered. When SE is refractory to these treatments, continuous IV infusion with midazolam, propofol, or a barbiturate suppresses seizure activity. Standard treatment protocols are useful in promoting rapid intervention with appropriate medications.
Relationship Disclosure: Dr Waterhouse has received research funding from GlaxoSmithKline, Supernus Pharmaceuticals, Inc., and UCB.
Unlabeled Use of Products/Investigational Use Disclosure: Dr Waterhouse discusses the use of antiepileptic drugs and anesthetic agents that have not been approved specifically for use in status epilepticus.