The multifaceted care of status epilepticus


Address correspondence to Eelco F. M. Wijdicks, Division of Critical Care Neurology, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, U.S.A. E-mail:


After seizures have been controlled, long-term care of status epilepticus may be needed and collectively involves every major organ. First, as a result of rapid escalation of antiepileptic drugs, there are initial concerns with hypotension, acid-base abnormalities, and cardiac arrhythmias. Second, refractory status epilepticus and the continuous need for intravenous administration of anesthetic drugs will lead to a multitude of systemic complications that require long-term complex care. Most anticipated problems are infectious complications with a high risk of pneumonia and sepsis, but thromboembolism due to immobilization and catheter placement are also common. If a good outcome is possible or anticipated in a patient with refractory status epilepticus, physicians should plan for a surveillance and treatment protocol to adequately support these patients.