31. Evaluating and Treating Status Epilepticus

  1. John W. Miller MD, PhD Director, UW Regional Epilepsy Center, Professor of Neurology and Neurological Surgery3 and
  2. Howard P. Goodkin MD, PhD The Shure Professor of Neurology and Pediatrics, Director, Division of Pediatric Neurology4
  1. Jeffrey Bolton1 and
  2. Howard P. Goodkin2

Published Online: 10 JAN 2014

DOI: 10.1002/9781118456989.ch31

Epilepsy

Epilepsy

How to Cite

Bolton, J. and Goodkin, H. P. (2014) Evaluating and Treating Status Epilepticus, in Epilepsy (eds J. W. Miller and H. P. Goodkin), John Wiley & Sons, Oxford. doi: 10.1002/9781118456989.ch31

Editor Information

  1. 3

    University of Washington, Seattle, WA, USA

  2. 4

    Department of Neurology, University of Virginia, Charlottesville, VA, USA

Author Information

  1. 1

    Department of Neurology, Boston Children's Hospital Division of Epilepsy, Harvard Medical School, Boston, MA, USA

  2. 2

    Division of Pediatric Neurology, Department of Neurology, University of Virginia, Charlottesville, VA, USA

Publication History

  1. Published Online: 10 JAN 2014
  2. Published Print: 14 FEB 2014

ISBN Information

Print ISBN: 9781118456941

Online ISBN: 9781118456989

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Keywords:

  • status epilepticus (SE);
  • nonconvulsive SE;
  • generalized convulsive SE;
  • benzodiazepine;
  • fosphenytoin;
  • phenytoin

Summary

Status epilepticus (SE) is characterized by a prolonged single, self-sustaining, continuous seizure or recurrent seizures without return to baseline. Whether convulsive or nonconvulsive, it is considered a neurological emergency and prompt treatment is crucial. Initial management of SE consists of basic resuscitation elements (the ABCs) as well as benzodiazepine administration. SE that is refractory to first- and second-line agents may require management in an ICU setting with continuous bedside EEG monitoring. The prognosis of SE is closely linked to underlying etiology, with mortality rates around 20%.