Status epilepticus: management and outcome of 107 episodes

Morbidity and mortality from status epilepticus might be reduced by attention to recommended management protocols. We studied our experience of 107 episodes of status epilepticus in 43 patients over a 5-year period. Overall mortality was 2% and permanent sequelae developed in 11 cases (10%). Although hospital admission was rapid, treatment could be initiated more quickly in the community (P < 0.0001). However treatment given before admission did not significantly reduce the duration of status (median difference 38 minutes, 95% C.I., 24 to 55 minutes). Diazepam was the first line treatment in 98 episodes, chlormethiazole and phenytoin were used in 27 and 18 episodes, respectively. Paraldehyde was used in 12 episodes. Midazolam was used in the intensive care setting in two cases. Clonazepam, lorazepam, lignocaine and phenobarbitone were not used at all. There was a marked failure to adhere to the recommended management protocols.