• Amish M Shah, Anita Vashi, and Andy Jagoda.
• Department of Emergency Medicine, Mount Sinai School of Medicine, ne Gustave Levy Place Box1490, New York, NY 10128, USA. amish.shah@mountsinai.org
• Emerg Med Australas. 2009 Oct 1;21(5):352-66.

AbstractStatus epilepticus (SE) is divided into convulsive and non-convulsive types; both are associated with significant morbidity and mortality. Although convulsive SE is easily recognized, non-convulsive SE remains an elusive diagnosis as physical signs are varied and subtle. Successful management depends on a comprehensive approach that involves diagnostic testing and pharmacological interventions while ensuring cerebral oxygenation and perfusion at all times. There are a limited number of well-designed studies to support the development of evidence-based recommendations for the management of SE, especially for the management of non-convulsive status. Benzodiazepines, specifically lorazepam, continue to be the most commonly recommended first-line therapy; best treatment for refractory status cases depends on resources available and must be tailored to the individual institution. In order to facilitate care, it is recommended that each institution develop a management protocol for these patients.

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