Status Epilepticus

Abstract

Status epilepticus (SE) is a life-threatening neurologic emergency with high mortality and morbidity. Although it was recognized many centuries ago, it was not until the middle of the nineteenth century that complications from continuous or prolonged seizures were first well described (1). Initially these recurring convulsive seizures were called “etat de mal epileptique” referring to repeated generalized motor seizures (2). Subsequently the term “status epilepticus” was used. Since then there have been numerous clinical descriptions and definitions of SE. Clinical research into this condition began an upsurge with Berger’s invention of the electroencephalogram (EEG), and the recognition of seizure as a clinical manifestation or “outward manifestation of a disordered rhythm of brain potentials” (3). Henri Gastaut led the first meeting devoted to status epilepticus in 1962 at the tenth Marseilles Colloquium. Over the past few decades, our understanding of SE has progressed through experimental and human research. The implications of prolonged seizures on the brain are increasingly understood. Progressive research into the neurochemical bases of SE has helped promote novel therapies to treat this life-threatening problem. Information obtained from recent experimental studies and antiepileptic drug trials recommend changes from the previous treatment algorithms and incorporation of new approaches in the management of SE patients. We will review the salient pathophysiologic, clinical, and therapeutic aspects of SE, which is a common entity in those patients admitted to the neurosciences critical care unit (NSU).