Status epilepticus--a review article

Abstract

Background: Status epilepticus is a neurological emergency associated with significant morbidity and mortality and outcome that are inversely related to duration of the condition. Any type of epileptic seizure can develop into status epilepticus (SE) but some types evolve into SE more commonly than others.

Methods: This article reviews both convulsive and non-convulsive types of SE with emphasis on generalised convulsive type the most commonly seen. The aetiology, pathophysiology, complications and drugs used in the management of SE are also discussed.

Results: To prevent complications resulting from the repeated seizures, prompt and aggressive management is essential and should proceed along four fronts: (a) Treatment of the SE (b) Prevention of recurrence (c) Management of potential precipitating causes and (d) Management of complication and underlying conditions. The morbidity and mortality associated with SE are often due to: (1) Injury from repetitive electrical discharge (2) Systemic stress from repeated generalised tonic-clonic seizure and (3) The damage to the central nervous system (CNS) caused by the acute insult precipitating the SE.

Conclusion: The sequelae resulting from SE can be life threatening. Therefore prompt treatment is very crucial with the attending physician having a low threshold for intensive care management.