Emergency department management of patients with status epilepticus.

Abstract

Status epilepticus is a neurological emergency requiring prompt intervention by emergency clinicians, as delays can lead to significant morbidity and mortality. Etiologies include acute causes such as electrolyte imbalance, infection, drugs, and acute strokes, as well as chronic causes such as remote brain injury, progressive epilepsies, and brain tumors. This issue presents evidence for an algorithmic approach to status epilepticus, from managing underlying causes and administering initial benzodiazepines, to second-line antiseizure agents, and escalating to intravenous anesthetics for refractory cases. Disposition for patients in status epilepticus includes inpatient care tailored to the patient's clinical needs, and appropriate follow-up.