Status Epilepticus

ABSTRACT

Generalized convulsive status epilepticus (GCSE) is a neurological emergency with high mortality which needs immediate recognition and treatment. There is a variety of different categories of status epilepticus (SE) and the form and aetiology of status are important predictors for prognosis. As early treatment is beneficial out-of-hospital treatment can be advised. The first-line treatment of GCSE is lorazepam which can be followed by phenytoin and induction of coma by anaesthetics. Because of receptor changes short-term prognosis to stop seizures becomes worse with time and the longterm prognosis is worst in case of refractory SE. Non convulsive forms of SE can only be diagnosed with an EEG and should be treated more cautiously to prevent potentially harmful adverse events of therapy. Some of the modern anticonvulsants which are available for intravenous use may have good efficacy and tolerability but are not licensed for use in SE, yet. Therefore, they should only be used with neurology specialist advise. For all institutions it is advisable to consent on an in-house protocol which all physicians are familiar with. This review gives a pragmatic overview of diagnosis, classification, and treatment of SE.

Keywords:

Convulsive status epilepticus, burst suppression, non-convulsive status epilepticus, refractory status epilepticus.