Abstract
Status epilepticus (SE) is a condition resulting from either a failure of the mechanisms responsible for seizure termination or the initiation of mechanisms leading to abnormally prolonged seizures (beyond time point t1). Status epilepticus is a condition that may have long-term consequences depending on the seizure type or duration of the prolonged seizure, including neuronal injury, neuronal structural changes, and neuronal cell death (beyond time point t2). Status epilepticus is classified according to several axes: semiology, etiology, EEG findings, and age. In clinical practice, classification based on semiology is most commonly applied, comprising two main types: convulsive status epilepticus and nonconvulsive status epilepticus. Nonconvulsive status epilepticus (NCSE) is defined as a seizure state without prominent motor manifestations lasting longer than 10 minutes. In comatose patients, if the EEG recording shows continuous epileptiform electrical activity persisting for more than 30 minutes within a 1-hour EEG recording (equivalent to >50% of the recording), this is also considered NCSE. Patients typically present with varying degrees of impaired consciousness. Focal status epilepticus without impairment of consciousness is rare. Treatment of status epilepticus follows the treatment guidelines of the American Epilepsy Society or the International League Against Epilepsy (ILAE), based on specific time milestones. Intravenous antiseizure medications are preferred as first-line treatment.
