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(Chest. 2004;126:582-591.)
© 2004 American College of Chest Physicians

The Management of Status Epilepticus*

Paul E. Marik, MD, FCCP and Joseph Varon, MD, FCCP

* From the Department of Critical Care Medicine (Dr. Marik), University of Pittsburgh Medical Center, Pittsburgh, PA; and The University of Texas Health Science Center at Houston (Dr. Varon), Baylor College of Medicine, St. Luke’s Episcopal Hospital, Houston, TX.

Correspondence to: Paul Marik, MD, FCCP, Professor of Critical Care, Department of Critical Care Medicine, University of Pittsburgh, 640A Scaife Hall, 3550 Terrace St, Pittsburgh, PA, 15261; e-mail: maripe{at}ccm.upmc.edu

Status epilepticus is a major medical emergency associated with significant morbidity and mortality. Status epilepticus is best defined as a continuous, generalized, convulsive seizure lasting > 5 min, or two or more seizures during which the patient does not return to baseline consciousness. Lorazepam in a dose of 0.1 mg/kg is the drug of first choice for terminating status epilepticus. Patients who continue to have clinical or EEG evidence of seizure activity after treatment with lorazepam should be considered to have refractory status epileptics and should be treated with a continuous infusion of propofol or midazolam. This article reviews current information regarding the management of status epilepticus in adults.

Key Words: anticonvulsants • barbiturates • lorazepam • midazolam • phenytoin • propofol • refractory status epilepticus • status epilepticus




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U. Idrees and M. Londner
Pharmacotherapy Overview of Seizure Management in the Adult Emergency Department
Journal of Pharmacy Practice, October 1, 2005; 18(5): 394 - 411.
[Abstract] [PDF]


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Copyright © 2004 by the American College of Chest Physicians.