Abstract
The management of convulsive status epilepticus (CSE) consists of simultaneous termination of the status epilepticus (SE) and determination and management of the underlying etiology. The operational definition of CSE is seizure activity lasting for more than 5 min or recurrent seizure activity with no recovery in between. Management of SE consists of stabilizing the patient along with early administration of abortive therapy and initiation of the workup for an underlying etiology. Early treatment of SE often starts with the use of benzodiazepines, best administered via parenteral route, based on recommendations by the American Epilepsy Society, Neurocritical Care Society, and the European Federation of Neurological Societies. Various formulations of midazolam, diazepam, and lorazepam have been investigated for out-of-hospital treatment of CSE. Subsequent second-line therapy consists of parenteral anti-seizure drugs (ASD) including phenytoin, phenobarbital, valproic acid, levetiracetam, and lacosamide. Evidence supporting the use of many of these ASDs is still lacking or being evaluated.
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