Abstract
Status epilepticus (SE) has an annual incidence exceeding 100,000 cases in the United States alone, of which more than 20% result in death. Thus, increased awareness of presentation, etiologies, and treatment of SE is essential in the practice of critical care medicine. This review discusses current definitions of SE, as well as its clinical presentation and classification. The recent literature on epidemiology is reviewed, including morbidity and mortality data. An overview of the systemic pathophysiologic effects of SE is presented. Finally, significant studies on the treatment of acute SE and refractory SE are reviewed, including the use of anticonvulsants, such as benzodiazepines, and other drugs.
Highlights
Status epilepticus (SE) is a medical and neurologic emergency
The definition of SE is based on the clinical manifestation, a prolonged seizure or a series of seizures during which the patient has incomplete recovery of consciousness, and duration
It has been proposed that an operational definition of SE should involve timing much shorter than 30 minutes [7]
Summary
As the issue of SE is often faced by practitioners of critical care, it is imperative that SE be recognized and treated as a medical emergency. Given the complex pathophysiology, being able to abort SE will contribute to a decrease in the systemic effects and neurologic injury. First line treatment with benzodiazepines, followed by the other agents discussed above, provide the maximal potential for successful management of SE
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