Status epilepticus

Status epilepticus is a life-threatening cerebral event. Within 1-2 minutes of seizure onset, massive recurrent cerebral discharges cause autonomic and endocrine dysfunction and loss of normal brain homeostasis. Intracerebral abnormalities become progressively worse and self-perpetuating the longer seizures continue. Seizures lasting 90 minutes or more may cause irreversible injury to selectively vulnerable neurons in the brain and permanent impairment of neurologic function. In addition, status epilepticus is associated with cumulative anoxia that affects almost every major organ system of the body and leads to progressive organ failure. To prevent permanent neurologic injury, the treatment of status epilepticus must be prompt, aggressive, and rational. Stop the seizures, restore homeostasis, perform a thorough diagnostic evaluation to determine the cause of status, and treat definitively.