Antiepileptic Drug Therapy for Status Epilepticus

Area of Science:

• Neurology
• Clinical Pharmacology

Background:

• Status epilepticus (SE) is a critical neurological emergency with diverse causes and presentations.
• Effective treatment requires managing the underlying etiology and rapid seizure termination with antiepileptic drugs (AEDs).

Purpose of the Study:

• To provide practical, staged recommendations for AED therapy in SE.
• To synthesize existing guidelines and literature for clinical application.

Main Methods:

• Review of existing guidelines and scientific literature.
• Development of staged treatment recommendations for SE by the Drug Committee of the Korean Epilepsy Society.

Main Results:

• High-quality evidence supports benzodiazepines as the first-line treatment for SE.
• Limited high-quality evidence exists for second- and third-line treatments; recommendations rely on case series and expert consensus.
• Treatment decisions should balance patient-specific factors, benefits, and risks.

Conclusions:

• Staged AED therapy is crucial for managing SE.
• Concurrent treatment of underlying etiologies is essential alongside AEDs.
• Further research is needed to strengthen evidence for later-stage SE treatments.