Status epilepticus is a relatively common medical and neurologic emergency that requires prompt evaluation and treatment. There are many different status epilepticus syndromes, defined by clinical features and EEG findings. Causes, prognoses, and treatments differ, and optimal evaluation and treatment requires an understanding of both the type of status epilepticus and the underlying cause. Some forms of status epilepticus have an excellent prognosis, whereas others have a high likelihood of mortality.
The clinical features and diagnosis of convulsive status epilepticus in adults is discussed here; treatment is reviewed separately. Nonconvulsive status epilepticus and the diagnosis and management of status epilepticus in children are also discussed separately. (See "Convulsive status epilepticus in adults: Treatment and prognosis" and "Nonconvulsive status epilepticus" and "Clinical features and complications of status epilepticus in children" and "Management of convulsive status epilepticus in children".)
The International League Against Epilepsy (ILAE) defined status epilepticus more than 20 years ago as a single epileptic seizure of >30 minutes duration or a series of epileptic seizures during which function is not regained between ictal events in a 30 minute period . This 30 minute criterion has been the standard in most epidemiologic studies .
Because of the clinical urgency in treating generalized convulsive status epilepticus (GCSE), however, a 30 minute definition is neither practical nor appropriate in clinical practice. Once seizures have continued for more than a few minutes, treatment should begin.
Considering the need for rapid evaluation and intervention in GCSE, an accepted operational definition of status epilepticus consists of the following [3,4]: