Advances in the Treatment of Status Epilepticus

The management of status epilepticus (SE) emphasizes early identification, support of vital functions, quick implementation of pharmacotherapy, and recognition of acute etiologies. Prompt administration of a benzodiazepine, often followed by an intravenous antiseizure medication, has been supported by multiple high-quality studies. SE evolving into a refractory stage may require the initiation of anesthetic agents, such as midazolam or propofol. The contribution of autoimmune encephalitis to the burden of refractory SE cases has led to the introduction of immune-modulatory agents, such as steroids and IVIG, in the treatment protocols for refractory SE appearing de novo without prior history of epilepsy. This chapter summarizes the pharmacological agents proposed in the treatment of SE and the stepped approach to their implementation.