Status Epilepticus

Status epilepticus is defined as continuous seizure activity for greater than 5 minutes or consecutive seizures without regaining consciousness over 5 minutes. Status epilepticus is common in the epilepsy population and is often associated with acute, severe neurological injury or illness such as traumatic brain injury (TBI), intracerebral hemorrhage (ICH), meningitis, or pharmacologic toxicity/withdrawal. Overall, the incidence of status epilepticus is about 12 per 100,000 individuals, a value that has increased 50% since the early 2000s (Dham 2014). Status epilepticus is often divided into “convulsive” status epilepticus (in which the patient has obvious clinical manifestations of seizures, mental status impairment, or postictal focal neurological deficits) and “nonconvulsive” status epilepticus (in which the patient has no obvious clinical manifestations of seizure, but seizure activity is revealed on electroencephalogram [EEG]). Refractory status epilepticus is defined as status epilepticus that persists despite treatment with at least two antiepileptic drugs. Outcomes and complications vary greatly among these types of status epilepticus (Treiman 1998).