8. Acute Management of Status Epilepticus

  1. Edward M. Manno MD, FCCM, FAAN, FAHA
  1. Jan Claassen MD, PhD

Published Online: 11 APR 2012

DOI: 10.1002/9781118297162.ch8

Emergency Management in Neurocritical Care

Emergency Management in Neurocritical Care

How to Cite

Claassen, J. (2012) Acute Management of Status Epilepticus, in Emergency Management in Neurocritical Care (ed E. M. Manno), Wiley-Blackwell, Oxford, UK. doi: 10.1002/9781118297162.ch8

Editor Information

  1. Neurological Intensive Care Unit Cleveland Clinic Cleveland, OH, USA

Author Information

  1. Division of Neurocritical Care and the Comprehensive Epilepsy Center, Department of Neurology, Columbia University, New York, NY, USA

Publication History

  1. Published Online: 11 APR 2012
  2. Published Print: 11 MAY 2012

Book Series:

  1. Neurology in Practice

Book Series Editors:

  1. Robert A. Gross and
  2. Jonathan W. Mink

Series Editor Information

  1. Department of Neurology, University of Rochester Medical Center, Rochester, NY, USA

ISBN Information

Print ISBN: 9780470654736

Online ISBN: 9781118297162



  • status epilepticus;
  • convulsions;
  • nonconvulsive;
  • treatment;
  • continuous EEG monitoring;
  • ICU;
  • refractory status epilepticus


Status epilepticus (SE) is a life-threatening medical emergency and requires prompt diagnosis and early treatment. Treatment efficacy and outcome are directly related to delays in starting therapy. Benzodiazepines such as lorazepam are first-line therapy usually followed by phenytoin/fosphenytoin. A low threshold should exist for an urgent EEG since electrographic seizures are frequent after control of convulsions. For refractory SE, continuous IV midazolam or propofol and IV valproate are options, and continuous IV pentobarbital is used for the most refractory cases.