{ "schemaVersion": 2, "eyebrow": "Neurologic emergency", "title": "Status Epilepticus", "summary": "Status epilepticus requires immediate seizure termination, cardiorespiratory support, etiologic evaluation, and EEG-guided escalation. Adequate early benzodiazepine dosing and prompt loading with a second-line antiseizure medication reduce avoidable progression to refractory status, while persistent impaired consciousness mandates assessment for nonconvulsive seizures.", "seoDescription": "Status epilepticus diagnosis and management: time-based benzodiazepines, second-line therapy, EEG monitoring, etiologic workup, and refractory seizure care.", "clinicalQuestion": "How should physicians rapidly diagnose, treat, monitor, and investigate convulsive and nonconvulsive status epilepticus?", "specialty": "Neurology and Neurocritical Care", "audience": "U.S. physicians and medical trainees", "tags": [ "status epilepticus", "convulsive status epilepticus", "nonconvulsive status epilepticus", "refractory status epilepticus", "continuous EEG", "benzodiazepines" ], "keyTakeaways": [ "Treat generalized convulsive seizure activity lasting 5 minutes or recurrent seizures without recovery as status epilepticus; do not await the historical 30-minute threshold. [15][18][21]", "Give one adequate benzodiazepine dose promptly while managing airway, ventilation, circulation, glucose, and reversible metabolic causes; benzodiazepine underdosing and delayed escalation are common implementation failures. [15][17]", "For benzodiazepine-resistant convulsive status epilepticus, IV levetiracetam, fosphenytoin, and valproate had similar efficacy in ESETT; select according to hepatic, cardiac, pregnancy, interaction, and behavioral considerations. [17][21]", "Persistent coma or encephalopathy after apparent convulsive seizure cessation requires urgent EEG because electrographic seizures and nonconvulsive status may lack major motor manifestations. [12][16][19]", "After failure of a benzodiazepine plus an appropriately dosed second-line antiseizure medication, manage in an ICU with continuous EEG and individualized consideration of anesthetic infusion therapy. [16][21]" ], "sections": [ { "id": "operational-recognition", "eyebrow": "Recognize", "heading": "Define the emergency and identify occult seizure activity", "intro": "Use a treatment threshold rather than waiting for prolonged injury thresholds.", "paragraphs": [ "For generalized convulsive status epilepticus, the operational treatment threshold is 5 minutes of continuous seizure activity or recurrent seizures without recovery. The ILAE framework distinguishes t1, when a seizure is unlikely to self-terminate, from t2, when prolonged activity may produce lasting consequences; for convulsive status, these are estimated at 5 and 30 minutes, respectively. [15][18][21]", "Convulsive status is primarily a clinical diagnosis. Nonconvulsive status epilepticus (NCSE) should be suspected in persistent or unexplained altered mental status, especially after convulsive activity, in critically ill patients, or with subtle ocular, facial, or distal motor findings. EEG is required to establish NCSE and to detect persistent electrographic seizures after neuromuscular blockade, sedation, or clinical motor cessation. [1][12][16][19]", "EEG interpretation requires clinical correlation. Salzburg-based criteria standardize assessment but may produce false-positive classifications from encephalopathic rhythmic or periodic patterns; expert review and longer recording improve diagnostic confidence. [1]" ], "bullets": [ "Escalate concern for an acute symptomatic cause in new-onset status, focal deficits, fever or immunosuppression, head trauma, toxic exposure, pregnancy, or absence of a prior epilepsy diagnosis. [12][19]", "In established epilepsy, immediately assess missed doses, recent antiseizure medication changes, subtherapeutic concentrations when measurable, alcohol or sedative withdrawal, and intercurrent illness. [16][19][21]" ], "subsections": [], "table": { "caption": "High-yield diagnostic actions in status epilepticus. [12][19]", "columns": [ "Clinical situation", "Immediate diagnostic action", "Reason for action" ], "rows": [ [ "Ongoing generalized convulsions", "Document onset time; check bedside glucose while initiating resuscitation and antiseizure treatment.", "Treatment and stabilization must proceed concurrently; hypoglycemia is a reversible cause. [12][19]" ], [ "Persistent impaired consciousness after convulsions", "Obtain urgent EEG; use continuous EEG when seizures persist, anesthetic infusions are used, or clinical examination is unreliable.", "Clinical motor cessation does not exclude electrographic seizures or NCSE. [12][16][19]" ], [ "New-onset or unexplained status", "Obtain targeted laboratory testing, neuroimaging, medication concentrations when applicable, and toxicology or CSF studies when indicated by presentation.", "Etiology directs urgent disease-specific treatment and prognosis. [12][19]" ] ] } }, { "id": "initial-stabilization", "eyebrow": "First 5 minutes", "heading": "Stabilize while terminating seizures", "intro": "Resuscitation and pharmacotherapy occur in parallel.", "paragraphs": [ "Assess and support airway, breathing, and circulation; apply cardiorespiratory monitoring, establish vascular access, obtain bedside glucose, and correct immediately identifiable metabolic causes. Obtain history from witnesses or EMS without delaying therapy. [12][15][19]", "Benzodiazepines are first-line therapy for convulsive status. Respiratory depression and hypotension require monitoring, but untreated convulsive status itself contributes substantially to respiratory and cardiorespiratory complications; fear of respiratory depression should not lead to inadequate treatment. [15]" ], "bullets": [ "Use IV lorazepam or IV diazepam when IV access is immediately available; the AES guideline found no significant difference in effectiveness between these agents. [15]", "If IV access is not established, IM midazolam is an evidence-based first-line option and was more effective than IV lorazepam in adults in the prehospital setting because it was delivered more rapidly. [15]", "Administer an adequate full initial dose rather than serial partial doses. Inadequate benzodiazepine dosing and delayed transition to second-line therapy are recurrent quality gaps. [15][13][17]", "Prepare a longer-acting second-line antiseizure medication as the benzodiazepine is given; do not wait for recurrent convulsions before planning sustained seizure control. [12][15][21]" ], "subsections": [], "table": { "caption": "First-line benzodiazepine regimens supported in supplied sources for convulsive status epilepticus. [15][21]", "columns": [ "Agent", "Route and dose", "Selection considerations" ], "rows": [ [ "Lorazepam", "IV 0.1 mg/kg in the AES-cited trials; adult fixed-dose regimens of 2–4 mg IV are described in adult review literature. [15][21]", "Effective first-line agent; monitor ventilation and blood pressure. [15][21]" ], [ "Diazepam", "IV 0.15 mg/kg in the AES-cited adult trial; adult review literature describes 10–20 mg IV at 5 mg/min. [15][21]", "Effective alternative to lorazepam; use a longer-acting antiseizure medication for sustained control. [15][21]" ], [ "Midazolam", "IM 10 mg for adults in RAMPART; adult review literature describes 10–20 mg by buccal, intranasal, or intramuscular routes. [15][21]", "Prefer when rapid IV access is unavailable; monitor for respiratory depression and hypotension. [15][21]" ] ] } }, { "id": "established-status", "eyebrow": "After benzodiazepines", "heading": "Load a second-line antiseizure medication without delay", "intro": "Choose one agent using patient-specific risk rather than presumed efficacy differences.", "paragraphs": [ "For benzodiazepine-resistant convulsive status epilepticus, ESETT found similar efficacy and primary safety outcomes for IV levetiracetam, fosphenytoin, and valproate across age groups. Thus, choice should be driven by contraindications, comorbidity, concomitant medications, and the anticipated maintenance regimen. [17][21]", "The evidence base for the AES 2016 guideline predates ESETT and rated several second-line options with lower certainty. More recent evidence supports clinical equipoise among levetiracetam, fosphenytoin, and valproate rather than a universal hierarchy. [15][17]" ], "bullets": [ "Levetiracetam: ESETT used 60 mg/kg IV over 10 minutes, maximum 4,500 mg. Favor when drug interactions or hepatic metabolism are major concerns; behavioral adverse effects may matter in patients with pre-existing behavioral or psychiatric vulnerability. [17][21]", "Fosphenytoin: ESETT used 20 mg phenytoin equivalents/kg IV over 10 minutes, maximum 1,500 mg. Avoid or use caution with conduction disease or clinically important arrhythmia risk; fosphenytoin is generally better tolerated than phenytoin. [15][21]", "Valproate: ESETT used 40 mg/kg IV over 10 minutes, maximum 3,000 mg. Avoid or use caution with severe hepatic disease, suspected mitochondrial dysfunction, and pregnancy; it may be particularly useful when generalized epilepsy is likely. [17][21]", "Phenobarbital remains an alternative but has clinically important respiratory depressant effects and may increase the need for airway support. [15][21]" ], "subsections": [], "table": { "caption": "Second-line medication selection after benzodiazepine-resistant convulsive status epilepticus. [17][21]", "columns": [ "Agent", "ESETT loading regimen", "Avoid or use caution", "Practical advantage" ], "rows": [ [ "Levetiracetam", "60 mg/kg IV over 10 minutes; maximum 4,500 mg. [17][21]", "Potential behavioral adverse effects. [21]", "Minimal hepatic metabolism and few drug interactions. [21]" ], [ "Fosphenytoin", "20 mg PE/kg IV over 10 minutes; maximum 1,500 mg. [17][21]", "Cardiac conduction disease or proarrhythmic risk. [21]", "Established IV loading option; better tolerated than phenytoin. [15][21]" ], [ "Valproate", "40 mg/kg IV over 10 minutes; maximum 3,000 mg. [17][21]", "Severe liver disease, mitochondrial dysfunction, and pregnancy. [21]", "Broad-spectrum option; may fit generalized epilepsy. [21]" ] ] } }, { "id": "refractory-and-ncse", "eyebrow": "ICU escalation", "heading": "Manage refractory status and NCSE with EEG-guided, etiology-directed care", "intro": "The risk-benefit balance of anesthetic coma differs by seizure type and underlying brain injury.", "paragraphs": [ "Refractory status epilepticus is commonly defined as continuing seizures after adequately dosed therapy with a benzodiazepine plus another antiseizure medication from a different class. Escalate to ICU-level care, obtain continuous EEG, reassess the diagnosis and etiology, and involve neurology or neurocritical care early. [16][21]", "For refractory convulsive status, propofol, midazolam, or barbiturate-based anesthesia are commonly used, but comparative trials do not establish superiority of one anesthetic strategy. The target is suppression of electrographic seizures; the incremental value of deeper burst suppression over seizure suppression alone remains uncertain. [16][21]", "NCSE is heterogeneous. Urgency is greatest when it follows convulsive status, occurs with acute brain injury, is associated with impaired consciousness, or has a convincing electroclinical correlate. Avoid reflexive escalation to anesthetic coma for every rhythmic or periodic EEG pattern; confirm the diagnosis, assess treatment response, and weigh iatrogenic hypotension, ventilation, and prolonged sedation against likely seizure-related harm. [1][16][18]" ], "bullets": [ "When intubation is required for respiratory failure or airway control, continued EEG is essential because paralysis masks motor seizure activity. [12][19]", "Maintain or initiate nonanesthetic antiseizure medications before attempting anesthetic weaning to reduce breakthrough seizures. [16][21]", "For super-refractory status, evidence for ketamine, immunotherapy, ketogenic diet, hypothermia, inhaled anesthetics, ECT, stimulation, and surgery is limited largely to small series, case reports, or selected observational evidence; treatment should be individualized in experienced centers. [16][21]", "Consider autoimmune, infectious, structural, metabolic, toxic, medication-related, and genetic causes early in new-onset refractory status; etiologic therapy may be as consequential as additional antiseizure medication. [12][16][21]" ], "subsections": [ { "heading": "Continuous EEG priorities", "paragraphs": [ "Use continuous EEG to confirm seizure termination, detect NCSE, guide anesthetic titration, and distinguish persistent ictal activity from nonepileptic movements or encephalopathic patterns. In critically ill patients, absence of early epileptiform abnormalities lowers the likelihood of later seizure detection, but monitoring duration should be individualized to the clinical context and initial EEG findings. [16]" ], "bullets": [ "A clinical improvement after an antiseizure medication trial supports but does not independently prove an ictal diagnosis; correlate clinical, electrographic, and physiologic changes. [1]", "Automated or rapid EEG technologies may shorten time to EEG acquisition, but do not replace expert interpretation for NCSE diagnosis. [2][17]" ] } ], "table": { "caption": "Escalation framework for ongoing seizures. [16][21]", "columns": [ "Clinical stage", "Core action", "Monitoring and reassessment" ], "rows": [ [ "Benzodiazepine-resistant status", "Load levetiracetam, fosphenytoin, or valproate; correct the precipitant concurrently. [17][21]", "Assess for clinical cessation, cardiorespiratory adverse effects, and need for EEG. [12][17]" ], [ "Refractory status", "ICU transfer; consider anesthetic infusion after failure of benzodiazepine plus a second-line agent. [16][21]", "Continuous EEG, hemodynamic support, serial etiologic reassessment. [16][21]" ], [ "Super-refractory status", "Reevaluate diagnosis and cause; use multidisciplinary, individualized rescue therapies in an experienced center. [16][21]", "Continuous EEG and active surveillance for infection, hypotension, rhabdomyolysis, renal injury, thrombosis, ileus, and pressure injury. [16]" ] ] } }, { "id": "etiology-and-quality", "eyebrow": "Do next", "heading": "Treat the cause and build systems that prevent delay", "intro": "Seizure termination alone is insufficient when the precipitant remains active.", "paragraphs": [ "Concurrent etiologic evaluation should include glucose; electrolytes including sodium, calcium, and magnesium; renal function; bicarbonate; blood count; antiseizure medication concentrations when relevant; pregnancy testing when applicable; and targeted toxicology, imaging, and CSF studies according to presentation. CT is often the most rapidly available imaging modality in the acute setting, while MRI can better define selected structural abnormalities when the patient is stabilized. [19]", "Practice variation is substantial. In one community-hospital cohort, 37.0% of initial benzodiazepine doses were below the minimum therapeutic dose, more than half of patients receiving both first- and second-line therapy had escalation delayed beyond 60 minutes, and 26.2% received markedly low second-line loading doses. [13]", "Institutional status protocols, medication order sets, seizure alerts, pharmacist participation, rapid EEG access, and audit of time-to-treatment metrics can improve execution of evidence-based care. Successful interventions require adaptation to local formulary, staffing, and EEG capacity. [17]" ], "bullets": [ "For patients with epilepsy and recurrent prolonged seizures, prescribe an individualized seizure action plan and ensure caregivers understand when and how to use rescue medication. [17]", "After acute control, reconcile home antiseizure therapy, address adherence and access barriers, document the suspected etiology, and arrange epilepsy or neurology follow-up. [17][19]", "Do not use an AI seizure-detection system as a diagnostic replacement for EEG. NCSE-specific automated models remain preliminary; one single-center proof-of-concept study used only 11 patients and segment-level rather than patient-level partitioning, limiting generalizability. [2]" ], "subsections": [], "table": { "caption": "Implementation metrics for institutional status epilepticus pathways. [13][17]", "columns": [ "Metric", "Why it matters", "Use for improvement" ], "rows": [ [ "Time from recognized seizure to first adequate benzodiazepine dose", "Early, adequate first-line treatment is central to preventing ongoing seizures and refractoriness. [15][17]", "Identify EMS, ED, medication-access, or dosing barriers. [17]" ], [ "Time from benzodiazepine to second-line loading", "Delays in escalation are common and may prolong seizure burden. [13][17]", "Use order sets, pre-mixed medication access, and defined team roles. [17]" ], [ "Time to EEG in persistent altered consciousness", "Delayed EEG can delay recognition of NCSE or electrographic recurrence. [17][19]", "Expand rapid or continuous EEG pathways where clinically feasible. [17]" ] ] } } ], "faq": [ { "question": "When is status epilepticus refractory?", "answer": "Refractory status epilepticus is commonly defined as persistent seizures after adequately dosed treatment with a benzodiazepine and a second antiseizure medication from a different class; ICU care and continuous EEG are then generally indicated. [16][21]" }, { "question": "Which second-line drug is preferred after benzodiazepines?", "answer": "No single agent is universally preferred. In ESETT, levetiracetam, fosphenytoin, and valproate had similar efficacy and primary safety outcomes; choose according to cardiac risk, liver disease, mitochondrial disease, pregnancy, interactions, and anticipated maintenance therapy. [17][21]" }, { "question": "Does persistent confusion after a convulsion require EEG?", "answer": "Yes. Persistent impaired consciousness after apparent motor seizure cessation should prompt urgent EEG evaluation for electrographic seizures or NCSE, particularly in critically ill patients or after sedatives or neuromuscular blockade. [12][16][19]" }, { "question": "Should every NCSE pattern be treated with anesthetic coma?", "answer": "No. NCSE and ictal-interictal EEG patterns are heterogeneous. Confirm electroclinical relevance, assess underlying brain injury and treatment response, and balance potential seizure-related harm against the morbidity of intubation, hypotension, and prolonged anesthetic exposure. 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LEV was given below 35 mg/kg … this", "score": 0.6161283 }, { "number": 7, "title": "Defining the end point of status epilepticus: A scoping ...", "detail": "onlinelibrary.wiley.com", "url": "https://onlinelibrary.wiley.com/doi/10.1002/epi.70169", "authors": "onlinelibrary.wiley.com", "host": "onlinelibrary.wiley.com", "snippet": "28 required a minimum cessation of SE duration of 24 h, the most frequently used threshold. Nine studies specified a duration of 48 h,", "score": 0.47329262 }, { "number": 8, "title": "Status Epilepticus", "detail": "journals.lww.com", "url": "https://journals.lww.com/continuum/fulltext/2015/10000/status_epilepticus.11.aspx", "authors": "journals.lww.com", "host": "journals.lww.com", "snippet": "Crossref\n\nGoogle Scholar\n\n7.\n\nKaplan PW. The clinical features, diagnosis, and prognosis of nonconvulsive status epilepticus. Neurologist 2005; 11 (6): 348–361.\n\nGoogle Scholar\n\n8.\n\nAvbersek A, Sisodiya S. Does the primary literature provide support for clinical signs used to distinguish psychogenic", "score": 0.45696765 }, { "number": 9, "title": "Status epilepticus in older adults: A critical review", "detail": "onlinelibrary.wiley.com", "url": "https://onlinelibrary.wiley.com/doi/10.1111/epi.18453", "authors": "onlinelibrary.wiley.com", "host": "onlinelibrary.wiley.com", "snippet": "Guidelines for the evaluation and management of status epilepticus. ... A clinical score for prognosis of status epilepticus in adults.", "score": 0.3467409 }, { "number": 10, "title": "Treatment adequacy outweighs treatment sequence in non ...", "detail": "onlinelibrary.wiley.com", "url": "https://onlinelibrary.wiley.com/doi/10.1002/epi.70297", "authors": "onlinelibrary.wiley.com", "host": "onlinelibrary.wiley.com", "snippet": "Prognosis reflects the relative contribution of epileptic brain dysfunction. When epileptic activity predominates, outcome is more likely to be", "score": 0.3413854 }, { "number": 11, "title": "Status Epilepticus - an overview", "detail": "www.sciencedirect.com", "url": "https://www.sciencedirect.com/topics/medicine-and-dentistry/status-epilepticus", "authors": "www.sciencedirect.com", "host": "www.sciencedirect.com", "snippet": "| Phase | Time | Management | Notes |\n| Stabilization | 0–5 min | 1. Evaluate and address ABC’s and place on monitors 2. Note time of seizure onset 3. Obtain finger stick glucose A. Treat <60 with 2 mL/kg D25 W 4. Obtain IV access 5. Treat identified reversible causes | _Labs to consider_:• Elect", "score": 0.6884899 }, { "number": 12, "title": "Diagnosis and management of status epilepticus: improving the status quo", "detail": "www.sciencedirect.com", "url": "https://www.sciencedirect.com/science/article/abs/pii/S1474442224004307", "authors": "www.sciencedirect.com", "host": "www.sciencedirect.com", "snippet": "as status epilepticus progresses can increase excitatory seizure-facilitating and decrease inhibitory seizure-terminating mechanisms at a cellular level. Effective clinical management requires rapid initiation of supportive measures, assessment of the cause of the seizure, and first-line treatment w", "score": 0.6601948 }, { "number": 13, "title": "Status epilepticus: Practice variation and adherence to treatment guideline in a large community hospital", "detail": "www.sciencedirect.com", "url": "https://www.sciencedirect.com/science/article/pii/S0022510X21002367", "authors": "www.sciencedirect.com", "host": "www.sciencedirect.com", "snippet": "### Conclusions\n\nPrompt and effective pharmacotherapy is the cornerstone of good SE treatment. Subtherapeutic doses of first-line benzodiazepines should be avoided. Benzodiazepine-resistant SE must be recognized early to facilitate rapid treatment escalation. The quality of second-line treatment suf", "score": 0.5855047 }, { "number": 14, "title": "Baxter Healthcare Corporation", "detail": "academic.oup.com", "url": "https://academic.oup.com/ajhp/article-pdf/45/6/1224/28458691/ajhp1224.pdf", "authors": "academic.oup.com", "host": "academic.oup.com", "snippet": "Alteration of the dosage regimen is necessary for patients with Impairment of renal function (SEE … at risk include patients with renal or hepatic impairment,", "score": 0.22586918 }, { "number": 15, "title": "Evidence-Based Guideline: Treatment of Convulsive Status Epilepticus in Children and Adults: Report of the Guideline Committee of the American Epilepsy Society - PMC", "detail": "pmc.ncbi.nlm.nih.gov", "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC4749120", "authors": "pmc.ncbi.nlm.nih.gov", "host": "pmc.ncbi.nlm.nih.gov", "snippet": "Each potentially relevant study found through this search methodology was abstracted for specific data, which were placed in evidence tables for further analysis. The review panel consisted of a group of neurologists, neurology nurses, emergency medicine physicians, clinical pharmacists, methodologi", "score": 0.82895297 }, { "number": 16, "title": "Status Epilepticus and Beyond: A Clinical Review of Status Epilepticus and an Update on Current Management Strategies in Super-refractory Status Epilepticus", "detail": "pmc.ncbi.nlm.nih.gov", "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC6786704", "authors": "pmc.ncbi.nlm.nih.gov", "host": "pmc.ncbi.nlm.nih.gov", "snippet": "56.Shafi MM, Westover MB, Cole AJ, Kilbride RD, Hoch DB, Cash SS. Absence of early epileptiform abnormalities predicts lack of seizures on continuous EEG. _Neurology_. 2012. 79:1796-801. doi: 10.1212/WNL.0b013e3182703fbc [DOI] [PMC free article] [PubMed] [Google Scholar]\n 57.Glauser T, Shinnar S, ", "score": 0.73505294 }, { "number": 17, "title": "Improving Quality of Care for Status Epilepticus: Putting Protocols into Practice - PMC", "detail": "pmc.ncbi.nlm.nih.gov", "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC11379039", "authors": "pmc.ncbi.nlm.nih.gov", "host": "pmc.ncbi.nlm.nih.gov", "snippet": "As highlighted in a recent review of 15 status epilepticus clinical practice guidelines by Vignatelli et al., critical elements of guideline quality such as applicability, stakeholder involvement, and rigor of development were poor . Low quality clinical guidelines have real life repercussions. Unav", "score": 0.70823324 }, { "number": 18, "title": "Commentary on SE Guidelines - PMC", "detail": "pmc.ncbi.nlm.nih.gov", "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC4749121", "authors": "pmc.ncbi.nlm.nih.gov", "host": "pmc.ncbi.nlm.nih.gov", "snippet": "1.Glauser T, Shinnar S, Gloss D, Alldredge B, Arya R, Bainbridge J, Mary Bare M, Bleck T, Dodson WE, Garrity L, Jagoda A, Lowenstein D, Pellock J, Riviello J, Sloan E, Treiman DM. Evidence-based guideline: Management of the treatment of convulsive status epilepticus in children and adults: Report of", "score": 0.66777676 }, { "number": 19, "title": "Status Epilepticus - StatPearls - NCBI Bookshelf", "detail": "www.ncbi.nlm.nih.gov", "url": "https://www.ncbi.nlm.nih.gov/books/NBK430686", "authors": "www.ncbi.nlm.nih.gov", "host": "www.ncbi.nlm.nih.gov", "snippet": "## Continuing Education Activity\n\nStatus epilepticus is a neurological emergency requiring immediate evaluation and management to prevent significant morbidity or mortality. Previously, status epilepticus was defined as a seizure with a duration equal to or greater than 30 minutes or a series of sei", "score": 0.62742686 }, { "number": 20, "title": "Seizure - StatPearls - NCBI Bookshelf - NIH", "detail": "www.ncbi.nlm.nih.gov", "url": "https://www.ncbi.nlm.nih.gov/books/NBK430765", "authors": "www.ncbi.nlm.nih.gov", "host": "www.ncbi.nlm.nih.gov", "snippet": "## Pearls and Other Issues\n\nMost generalized seizures terminate in less than 5 minutes, and a seizure of longer duration or serial seizures without regaining full consciousness in between define status epilepticus. Whether status epilepticus is from provoked causes or unprovoked causes, initial trea", "score": 0.23941201 }, { "number": 21, "title": "Modern Treatment of Status Epilepticus in Adults - Epilepsy - NCBI Bookshelf", "detail": "www.ncbi.nlm.nih.gov", "url": "https://www.ncbi.nlm.nih.gov/books/NBK580620", "authors": "www.ncbi.nlm.nih.gov", "host": "www.ncbi.nlm.nih.gov", "snippet": "clinical outcome at three months post SE. Common adverse effects included deep vein thrombosis, coagulopathy, increased risk for infection, and hemodynamic alterations including bradycardia and hypotension (121, 122). [...] To date, lacosamide has been used in a limited number of SE. In their review", "score": 0.23935866 }, { "number": 22, "title": "Epilepsy", "detail": "www.who.int", "url": "https://www.who.int/news-room/fact-sheets/detail/epilepsy", "authors": "www.who.int", "host": "www.who.int", "snippet": "## Signs and symptoms\n\nCharacteristics of seizures vary and depend on where in the brain the disturbance first starts, and how far it spreads. Temporary symptoms occur, such as loss of awareness or consciousness, and disturbances of movement, sensation (including vision, hearing and taste), mood, or", "score": 0.21937971 }, { "number": 23, "title": "Generalized convulsive status epilepticus in the adult", "detail": "www.ccjm.org", "url": "https://www.ccjm.org/lookup/external-ref?access_num=8462489&link_type=MED&atom=%2Fccjom%2F83%2F2%2F116.atom", "authors": "www.ccjm.org", "host": "www.ccjm.org", "snippet": "by DM Treiman · 1993 · Cited by 171 — Status epilepticus (SE) is defined as recurrent epileptic seizures without full recovery of consciousness before the next seizure begins,", "score": 0.1920998 }, { "number": 24, "title": "Guidelines for the evaluation and management of status epilepticus - PubMed", "detail": "www.ccjm.org", "url": "https://www.ccjm.org/lookup/external-ref?access_num=22528274&link_type=MED&atom=%2Fccjom%2F83%2F2%2F116.atom", "authors": "www.ccjm.org", "host": "www.ccjm.org", "snippet": "Status epilepticus (SE) treatment strategies vary substantially from one institution to another due to the lack of data to support one treatment over another. To provide guidance for the acute treatment of SE in critically ill patients, the Neurocritical Care Society organized a writing committee to", "score": 0.72278196 } ], "publishedAt": "2026-08-20T23:39:38.141730Z", "updatedAt": "2026-08-20T23:39:38.141730Z", "readingMinutes": 6, "slug": "status-epilepticus" }