title: Recent advances in status epilepticus.
abstract: OBJECTIVE
  This review discusses advances in the understanding of the mechanisms of status epilepticus and its current treatment approaches. Many of these have been topics at the 5th London-Innsbruck Colloquium on status epilepticus 2015.
  
  
  RESULTS
  A new definition and classification of status epilepticus was proposed, which is expected to improve treatment and stimulate research. A better understanding of the failure of seizure suppressing mechanisms and the initiation of self-sustaining seizures begins to translate into the clinical arena. Drugs, such as allopregnanolone, cannabinoids, sec-butylpropylacetamide and valnoctamide, may better target these seizure-perpetuating mechanisms. The concept of combinatorial treatments has further developed, but yet trials in humans are lacking. A new prognostic outcome-score and electroencephalography-criteria for nonconvulsive status epilepticus are ready for clinical use. Alternative routes, such as intranasal or buccal, have been explored in a number of trials suggesting that intramuscular midazolam is at least as effective as intravenous lorazepam and buccal or intranasal midazolam is at least as effective as rectal diazepam.
  
  
  CONCLUSIONS
  Despite progress in basic science, translation into the clinical field remains difficult. There is hope, that the two large phase III studies in the established and refractory status that started recruitment in 2015 will better inform the clinicians in this emergency situation.
authors.affiliation: aDepartment of Neurology, Christian Doppler Medical Centre, Paracelsus Medical University bCentre for Cognitive Neuroscience, Salzburg, Austria cDepartment of Neurological, Biomedical and Movement Sciences, Section of Clinical Neurology, University of Verona, Verona dDepartment of Neurology, Franz Tappeiner Hospital, Merano, Italy eUCL Institute of Neurology, National Hospital for Neurology and Neurosurgery, Queen Square, London, UK.
authors.forename: Eugen
authors.initials: E
authors.lastname: Trinka
authors.forename: Francesco
authors.initials: F
authors.lastname: Brigo
authors.forename: Simon
authors.initials: S
authors.lastname: Shorvon
mesh_terms: D000577:Amides / Q000627:therapeutic use; D000927:Anticonvulsants / Q000627:therapeutic use*; D003975:Diazepam / Q000627:therapeutic use*; D006801:Humans; D008874:Midazolam / Q000627:therapeutic use*; D012640:Seizures / Q000188:drug therapy*; D013226:Status Epilepticus / Q000188:drug therapy*
chemical_list: D000577:Amides; D000927:Anticonvulsants; C045179:valnoctamide; D003975:Diazepam; D008874:Midazolam