Introduction-how status epilepticus is caused

Status epilepticus (SE) is a term used to describe a prolonged, self-sustained seizure that may have overt, subtle, or no behavioral manifestations typically in association with a persistent ictal electroencephalographic (EEG) pattern. Given that patients who present in either convulsive or non-convulsive forms of SE are at risk for death or subsequent neurological morbidity, all forms of SE are considered a neurological emergency. Factors identified as potentially increasing the risk of mortality and morbidity include certain etiologies, age >60 years, and increasing seizure duration. Seizure duration is the most easily effected on presentation, and the prompt and early termination of SE is of utmost importance in improving outcome. Prompt, early termination is also important as the effectiveness of current first-line therapies is inversely related to seizure duration. Clinical overview Definition and classification Status epilepticus can present in many forms but there is currently no single well-accepted, precise definition or classification system for SE. Widely used clinical definitions include non-specific terminology such as a “seizure of sufficient length of time or is repeated frequently enough to produce a fixed or enduring epileptic condition” (Gastaut 1983) or “a seizure that shows no clinical signs of arresting after a duration encompassing the great majority of seizures of that type in most patients or recurrent seizures without resumption of baseline central nervous system function” (ILAE 1989).