Treatment of status epilepticus

Abstract

Generalized convulsive status epilepticus is a neurologic and medical emergency, with significant morbidity and mortality. First-line treatment includes administration of intravenous benzodiazepines. Second-line agents include intravenous phenytoin, phenobarbital, valproate and levetiracetam. Refractory status epilepticus necessitates the use of anesthetic agents such as pentobarbital, midazolam or propofol, with monitoring of treatment effect by continuous EEG. Nonconvulsive status epilepticus should be treated expeditiously but is not as threatening to health as convulsive status epilepticus.