Status epilepticus: an intensive care medicine problem

Status epilepticus (SE) is a major neurological emergency associated with significant morbidity and mortality. Whilst there are many definitions of SE, the operational definition as a seizure lasting greater than 5 minutes is widely implemented to ensure there is no delay in emergency treatment. After initial resuscitative assessment and first-line treatment these patients frequently require admission to the intensive care unit for both continuing physiological support and specific second- and third-line therapies if the SE remains unresolved. It is vital that the critical care clinician understands the potential aetiology, pathophysiology, appropriate investigations as well as the pharmacological management of patients with SE. This article will arm the critical are trainee with the theoretical knowledge required to effectively manage this particularly vulnerable cohort of patients.