Has the mortality of status epilepticus changed over the past few decades?

Earlier and more aggressive treatment of status epilepticus has long been established orthodoxy. In addi-tion to increasing therapeutic options, it is of critical importance to understand whether or not this has translated into improved prognosis. In this review, we examine the evidence as to whether the mortality of convulsive status epilepticus changed over the past few decades. In particular, we discuss a recent sys-tematic review and meta-analysis examining this question and its implications. We discuss potential rea-sons why there is no evidence of improved prognosis in terms of mortality and ways in which this may be addressed. Finally, we advocate the urgent need for accurate data on functional outcomes in non-fatal cases of status epilepticus.This paper was presented at the 8th London-Innsbruck Colloquium on Status Epilepticus and Acute Seizures held in September 2022.(c) 2022 Elsevier Inc. All rights reserved.

Automated summary

Earlier and more aggressive treatment of status epilepticus has long been established as the accepted approach, but it is important to assess whether this has led to improved prognosis. This review examines the evidence on changes in mortality of convulsive status epilepticus over time, focusing on a recent systematic review and meta-analysis. The lack of evidence for improved prognosis in terms of mortality is discussed, as well as potential reasons and possible solutions. The urgent need for accurate data on functional outcomes in non-fatal cases of status epilepticus is emphasized.