Der Nervenarzt
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Status epilepticus (SE) is a medical emergency. For diagnostic purposes EEG is mandatory when motor phenomena are absent or when a single seizure evolves into SE with impaired consciousness. The EEG may show focal or generalized status patterns, which must be distinguished from encephalopathies. ⋯ In this phase, only phenytoin is licensed. A generalized tonic-clonic status which is refractory is then treated with anesthetics including midazolam, disoprivan, or thiopental. The goal is to achieve burst suppression in the EEG and coadministration of antiepileptic drugs.
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Neuroimaging is crucial for the diagnosis of epilepsy, in particular for syndromic diagnosis of focal epilepsies and for presurgical evaluation. We give recommendations on the optimized acquisition of MRI and discuss the principle and role of additional neuroimaging methods including nuclear medicine and image processing.