Status epilepticus-Detection and treatment in the intensive care unit

Status epilepticus is characterized by persistent or repetitive seizures which, without successful treatment, can lead to neuronal damage, neurological deficits and death of the patient. While status epilepticus with motor symptoms can usually be clinically diagnosed, nonconvulsive status epilepticus is often clinically overlooked due to its ambiguous semiology, so that electroencephalography (EEG) recording is necessary. The treatment of status epilepticus is performed in four treatment steps, whereby a difficult to treat status epilepticus is present from the third step at the latest and intensive medical care of the patient is necessary. Timely initiation of treatment and sufficient dosage of anticonvulsive medication are decisive for the success of treatment. There is little evidence for the late stages of treatment. Intensive medical measures pose the risk of complications that worsen the prognosis. Especially in nonconvulsive status epilepticus, the use of anesthetics must be weighed against possible complications of mechanical ventilation.

Automated summary

Status epilepticus refers to persistent or repetitive seizures that, if left untreated, can cause neuronal damage, neurological deficits, and death. Motor symptoms are usually indicative of status epilepticus, but nonconvulsive status epilepticus often goes unnoticed clinically and requires electroencephalography (EEG) recording for diagnosis. Treatment involves four steps, with intensive medical care necessary from the third step onwards for difficult-to-treat cases. Timely initiation of treatment and proper medication dosage are crucial for successful treatment. There is limited evidence for the later stages of treatment, and intensive medical measures carry the risk of complications that may worsen the prognosis. In nonconvulsive status epilepticus, the use of anesthetics must be carefully considered due to potential complications with mechanical ventilation.