Statusepilepticus(SE)isdefinedasaseizurelastinglongerthan5min,oratleasttwo

seizureswithoutfullrecoveryofconsciousnessbetweenthem.Earlyemergentmedical
managementconsistsoflifesupportandanetiologysurvey,andsubsequenttreatment
canbeclassifiedinto4stages:(1)earlySE,

establishedSE,(3)refractorySE,and(4)superrefractorySE.ForearlySE,benzodiazepines,such as
lorazepamanddiazepam,aretheagentsofchoice,giventoterminatetheseizureactivityrapidly.ForestablishedSE(2030
minafterSEonset),thetherapeuticstrategyistogiveparentalantiepilepticdrugs,suchasphenytoin,valproicacid,and
levetiracetam.AtthestageofrefractorySE(12hoursafterSEonset),theconventionaltreatmentisinductionofgeneral
anesthesiausingmidazolamorpropofol.SuperrefractorySEisdefinedasSEthatcontinues,orrecurs,foratleast24hours
aftertheonset ofanesthetictherapy.In addition to treatments used in established and refractory SE, other potentially
effective therapies include ketamine, magnesium, inhalational anesthetics, immunotherapy, ketogenic diet, induced
hypothermia, and neurosurgery. The principle of SE therapy is rapid seizure control and correction of underlying
problems.Futurewelldesignedclinicaltrials are mandatory to establish the standard treatment, especially in settings of
established,refractory,andsuperrefractorySE.

Statusepilepticus(SE)isdefinedasaseizurelastinglongerthan5min,oratleasttwoseizureswithoutfull
recoveryofconsciousnessbetweenthem.Earlyemergentmedicalmanagementconsistsoflifesupportandan
etiologysurvey,andsubsequenttreatmentcanbeclassifiedinto4stages:(1)earlySE,

establishedSE,(3)refractorySE,and(4)superrefractorySE.ForearlySE,benzodiazepines,suchaslorazepamanddiazepam,arethe
agentsofchoice,giventoterminatetheseizureactivityrapidly.ForestablishedSE(2030minafterSEonset),thetherapeuticstrategyistogiveparental
antiepilepticdrugs,suchasphenytoin,valproicacid,andlevetiracetam.AtthestageofrefractorySE(12hoursafterSEonset),theconventionaltreatmentis
inductionofgeneralanesthesiausingmidazolamorpropofol.SuperrefractorySEisdefinedasSEthatcontinues,orrecurs,foratleast24hoursafterthe
onset of anesthetic therapy. In addition to treatments used in established and refractory SE, other potentially effective therapies include ketamine,
magnesium,inhalationalanesthetics,immunotherapy,ketogenicdiet,induced hypothermia, andneurosurgery.The principle of SE therapy is rapid
seizurecontrolandcorrectionofunderlyingproblems.Futurewelldesignedclinicaltrialsaremandatorytoestablishthestandardtreatment,especiallyin
settingsofestablished,refractory,andsuperrefractorySE.

Statusepilepticus(SE)isdefinedasaseizurelastinglongerthan5min,oratleasttwoseizureswithoutfull
recoveryofconsciousnessbetweenthem.Earlyemergentmedicalmanagementconsistsoflifesupportandan
etiologysurvey,andsubsequenttreatmentcanbeclassifiedinto4stages:(1)earlySE,

establishedSE,(3)refractorySE,and(4)superrefractorySE.ForearlySE,benzodiazepines,suchaslorazepamanddiazepam,arethe
agentsofchoice,giventoterminatetheseizureactivityrapidly.ForestablishedSE(2030minafterSEonset),thetherapeuticstrategyistogiveparental
antiepilepticdrugs,suchasphenytoin,valproicacid,andlevetiracetam.AtthestageofrefractorySE(12hoursafterSEonset),theconventionaltreatmentis
inductionofgeneralanesthesiausingmidazolamorpropofol.SuperrefractorySEisdefinedasSEthatcontinues,orrecurs,foratleast24hoursafterthe
onset of anesthetic therapy. In addition to treatments used in established and refractory SE, other potentially effective therapies include ketamine,
magnesium,inhalationalanesthetics,immunotherapy,ketogenicdiet,induced hypothermia, andneurosurgery.The principle of SE therapy is rapid
seizurecontrolandcorrectionofunderlyingproblems.Futurewelldesignedclinicaltrialsaremandatorytoestablishthestandardtreatment,especiallyin
settingsofestablished,refractory,andsuperrefractorySE.

Statusepilepticus(SE)isdefinedasaseizurelastinglongerthan5min,oratleasttwoseizureswithoutfull
recoveryofconsciousnessbetweenthem.Earlyemergentmedicalmanagementconsistsoflifesupportandan
etiologysurvey,andsubsequenttreatmentcanbeclassifiedinto4stages:(1)earlySE,

establishedSE,(3)refractorySE,and(4)superrefractorySE.ForearlySE,benzodiazepines,suchaslorazepamanddiazepam,arethe
agentsofchoice,giventoterminatetheseizureactivityrapidly.ForestablishedSE(2030minafterSEonset),thetherapeuticstrategyistogiveparental
antiepilepticdrugs,suchasphenytoin,valproicacid,andlevetiracetam.AtthestageofrefractorySE(12hoursafterSEonset),theconventionaltreatmentis
inductionofgeneralanesthesiausingmidazolamorpropofol.SuperrefractorySEisdefinedasSEthatcontinues,orrecurs,foratleast24hoursafterthe
onset of anesthetic therapy. In addition to treatments used in established and refractory SE, other potentially effective therapies include ketamine,
magnesium,inhalationalanesthetics,immunotherapy,ketogenicdiet,induced hypothermia, andneurosurgery.The principle of SE therapy is rapid
seizurecontrolandcorrectionofunderlyingproblems.Futurewelldesignedclinicaltrialsaremandatorytoestablishthestandardtreatment,especiallyin

settingsofestablished,refractory,andsuperrefractorySE.