Management of status epilepticus

Excerpt

Between 12 and 30 % of all newly diagnosed epilepsy patients will present in status epilepticus (SE) (continuous seizures lasting at least 5 min or two or more discrete seizures between which there is incomplete recovery of consciousness) and is one of the commonest neurological emergencies. Furthermore, SE carries a mortality of up to 20 % and it is well established that prompt termination improves outcome. A working knowledge of the evidence for acute treatment is therefore essential, not only for effective acute management, but also to prevent recurrence. However, evidence for guidance on management has often fallen short of contemporary standards as it has been problematic to construct randomised controlled trials for interventions in SE as a result of ethical complexities around consent and dogma surrounding existing guidelines. As a result, acute management has commonly been based on idealised pharmacokinetics and a desire to avoid unwanted side effects. …