A life-threatening neurologic condition defined as 5 or more minutes of either continuous seizure activity or repetitive seizures without regaining consciousness.
Generalized convulsive status epilepticus (SE) in both its subtle and overt subtypes constitutes the most frequent variant.
Diagnosis of nonconvulsive SE can be difficult, but recognition is crucial because rapid termination helps prevent serious brain injury, especially in patients with impaired consciousness.
In most cases, treatment must precede any thorough investigation and must be initiated as soon as SE is suspected.
Treatment involves a stepwise medication approach aimed at aborting the clinical and electrographic seizures.
Carries a high mortality rate and may cause serious complications if not promptly treated.
Generalized convulsive and nonconvulsive status epilepticus (SE) are neurologic and medical emergencies defined as 5 or more minutes of either continuous seizure activity or repetitive seizures with no intervening recovery of consciousness.  Traditionally SE was defined as 30 or more minutes;  however, this time frame has been reduced to 5 minutes to emphasize the seriousness of the condition and the urgency to prompt treatment. Conversely, simple partial SE does not usually involve alteration of consciousness. Seizures are often localized to the part of the body in which they originate, and motor activity can last for hours, days, or even longer.
Associate Professor of Neurology
Division of Epilepsy
Vanderbilt University Medical Center
NJA declares that he has no competing interests.
Dr Nabil J. Azar would like to gratefully acknowledge Dr Mohammad Z. Koubeissi, the previous contributor to this monograph. MZK declares that he has no competing interests.
Professor of Neurology and Neurosurgery
Johns Hopkins Medical Institutions
RPL's wife has shares in Abbott Laboratories, which makes Depakote, a brand formulation of valproate.
John Radcliffe Hospital
YH has been reimbursed by UCB Pharma Ltd, Janssen-Cilag Ltd, Pfizer Ltd, and Eisai Ltd for attending conferences; has taught at meetings sponsored by the above companies and by GlaxoSmithKline Services Unlimited; and has received payment for advisory board work from UCB Pharma Ltd, Janssen-Cilag Ltd, Eisai Ltd, and GlaxoSmithKline Services Unlimited.
Use of this content is subject to our disclaimer