Status Epilepticus

Status epilepticus is characterised by prolonged seizure activity, with varying definitions based on seizure type and duration. Approximately half of the cases occur de novo , in individuals without a prior history of epilepsy. The underlying causes can include brain tumours, infections, acute brain injury, metabolic disorders, or withdrawal from antiseizure medication in people with epilepsy. Convulsive status epilepticus is a medical emergency requiring immediate treatment in a staged protocol. The longer the status epilepticus persists, the poorer the prognosis and the more challenging it becomes to treat. Initial treatment is with benzodiazepines, but if seizures continue, intravenous therapy with phenytoin, levetiracetam, or valproate is necessary. Drug-resistant cases necessitate admission to intensive care units and anaesthesia. In contrast, non-convulsive status epilepticus usually requires a less aggressive treatment approach that depends upon age, underlying aetiology and degree of consciousness.