Status epilepticus

Status epilepticus (SE) still results in significant mortality and morbidity. Whereas mortality depends mainly on the age of the patient as well as etiology, morbidity often results from a myriad of complications that occur during prolonged admission to an intensive care environment. Although SE is a clinical diagnosis in most cases (convulsant), its treatment requires support by continuous electroencephalographic recording to ensure cessation of potential nonconvulsive elements of SE. Treatment must be initiated as early as possible and consists of benzodiazepine administration and supportive measures for the airway and circulation. These initial interventions are followed by effective intravenous antiepileptic drugs. If the SE becomes refractory, more complex intensive care interventions, such as induction of barbiturate coma, need to be pursued. Data regarding the role of more recently available antiepileptic drugs in treating SE also are discussed in this review.