title: Emergency Neurological Life Support: Status Epilepticus.
abstract: Patients with prolonged or rapidly recurring convulsions lasting more than 5 min are in status epilepticus (SE) and require immediate resuscitation. Although there are relatively few randomized clinical trials, available evidence and experience suggest that early and aggressive treatment of SE improves patient outcomes, for which reason this was chosen as an Emergency Neurological Life Support protocol. The current approach to the emergency treatment of SE emphasizes rapid initiation of adequate doses of first-line therapy, as well as accelerated second-line anticonvulsant drugs and induced coma when these fail, coupled with admission to a unit capable of neurological critical care and electroencephalography monitoring. This protocol will focus on the initial treatment of SE but also review subsequent steps in the protocol once the patient is hospitalized.
authors.affiliation: Division of Critical Care Neurology, Columbia University College of Physicians & Surgeons, New York, USA. jc1439@columbia.edu.
authors.forename: Jan
authors.initials: J
authors.lastname: Claassen
authors.affiliation: Division of Child Neurology, Columbia University College of Physicians & Surgeons, New York, USA.
authors.forename: James J
authors.initials: JJ
authors.lastname: Riviello
authors.affiliation: Department of Emergency Medicine, University of Michigan, Ann Arbor, USA.
authors.forename: Robert
authors.initials: R
authors.lastname: Silbergleit
mesh_terms: D004638:Emergency Treatment / Q000379:methods*; D006801:Humans; D008020:Life Support Care / Q000379:methods*; D009462:Neurology / Q000379:methods*; D013226:Status Epilepticus / Q000628:therapy*
keywords: Anticonvulsant; EEG monitoring; Pharmacologic coma; Protocol; Seizures; Status epilepticus