Status epilepticus (SE) is a neurological emergency defined as 5 minutes or more of continuous seizure activity or recurrent seizures without a return to baseline between seizures. Previous definitions required seizure activity to last for at least 30 minutes before being considered SE. However, earlier intervention is required to reduce morbidity and mortality from permanent neuronal damage. Treatment of SE centers on rapid control of seizures with benzodiazepines in the emergent-control phase, followed by urgent-control therapy with intravenous antiepileptic drugs (AEDs) to prevent further seizures. Patients whose seizures do not respond to adequate urgent- and emergent-control therapy are considered to have refractory SE (RSE). The longer patients’ seizures last, the more difficult it is to terminate the seizures, often requiring multiple AEDs, intubation, and continuous-infusion anesthetic medications to achieve seizure termination.

Status epilepticus should be treated with rapidly administered,...

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