Treatment: Status Epilepticus

GCSE is a medical emergency and must be treated immediately.

• First attend to any acute cardiorespiratory problems or hyperthermia.
• Perform a brief medical and neurologic examination, establish venous access, and send laboratory tests results to screen for metabolic abnormalities including anticonvulsant levels if pt has a history of epilepsy.
• Anticonvulsant therapy should then begin without delay (Fig. 22-1)
• In parallel, it is essential to determine the cause of the seizures to prevent recurrence and treat any underlying abnormalities.

The treatment of nonconvulsive status epilepticus is somewhat less urgent because the ongoing seizures are not accompanied by the severe metabolic disturbances of GCSE; however, evidence suggests cellular injury in the region of the seizure focus, so the condition should be treated as promptly as possible using the general approach for GCSE.