Neurocritical Care: Status Epilepticus Review

Status epilepticus (SE) is a life-threatening medical and neurologic emergency requiring prompt recognition and treatment. SE may be classified into convulsive and nonconvulsive, based on the presence of rhythmic jerking of the extremities. Refractory status epilepticus is defined as ongoing seizures failing to respond to first- and second-line anticonvulsant drug therapy and carries a high morbidity and mortality. Treatment efficacy, morbidity, and mortality are directly related to delays in starting therapy. Benzodiazepines are first-line therapy, usually followed by phenytoin/fosphenytoin or valropoic acid. A low threshold should exist for obtaining an urgent electroencephalogram.