Management of status epilepticus

Convulsive status epilepticus (CSE) is a neurological emergency. It can be the brain’s response to a variety of acute cerebral insults, or a complication of chronic neurological conditions. Management focuses on maintaining vital functions, stopping the seizure and identifying and treating the underlying cause. Morbidity and mortality have improved over recent years, probably because of more aggressive use of anti-convulsant medication in the acute phase and improved paediatric emergency and intensive care. Neurological sequelae are cause- and age-dependent. The highest morbidity and mortality is seen in the group of children with symptomatic CSE. More accurate epidemiological data is now being gathered on CSE in children, which has refined our understanding of the problem. Much work has gone into the development of evidence-based national guidelines on the optimal management in children, and new evidence from both epidemiological studies and the Cochrane review are informing improvements to the guidelines.