Status epilepticus: a major neurological emergency

Abstract

Background. Status epilepticus (SE) remains a common medical and neurological emergency with a high annual incidence, morbidity, and substantial mortality. Objective of the study. To provide an overview of SE as a life-threatening neurological emergency and the adequate treatment strategies of this condition. Material and methods. The analysis of literature of online resources from PubMеd, Mеdlinе, Mеdsсаpе, Hinаri, ILAE official website, MDPI were performed based on the descriptive and narrative literature review of the sources published in the period 2015-2023. Results. SE is etiologically most frequently represented by sudden cessation of antiepileptic treatment, followed by symptomatic and structural causes, and the highest mortality is noted in anoxic etiology. Clinical SE manifests as convulsive and nonconvulsive, the last presenting diagnostic difficulties. Timely, it is divided into early SE, established, refractory and superefractory SE. The treatment is staged and indicated as early as possible. The main strategies are treating the causes, early treatment to prevent brain damage like as long-term consequences, and the staged treatment approach adapted to the pathophysiological changes. EEG monitoring plays a crucial role in establishing the diagnosis and further evaluation. Conclusion. SE represents a major neurological emergency that requires an urgent evaluation and treatment initiation due to the risk of complications leading to high rates of morbidity, disability, and mortality. The aim of the management is the cessation of seizures and epileptiform activity as soon as possible and the support of the patient’s respiratory and cardiovascular functions.