Epidemiology

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Etiology

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Pathophysiology

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Clinical features

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Diagnostics

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Treatment

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Acute management

• Early status epilepticus (5–20 minutes): first-line therapy
  • IV benzodiazepine (lorazepam OR diazepam)
• Persistent status epilepticus (20–40 minutes): second-line therapy
  • IV fosphenytoin
  • IV valproic acid
  • IV levetiracetam
• Refractory status epilepticus (40–60 minutes)
  • Options include repeat second-line therapy or induction of coma (e.g., with IV propofol, thiopental, midazolam, or pentobarbital).

Long-term management

• Focal
  • Lamotrigine
  • Levetiracetam
  • Phenytoin
  • Carbamazepine
  • Oxcarbazepine
  • Phenobarbital (children)
• Generalized
  • Tonic-clonic
    • Lamotrigine
    • Valproate
    • Phenobarbital (children)
  • Typical absence
    • Ethosuximide
    • Valproate
  • Atypical absence
    • Valproate
  • Myoclonic
    • Valproate
    • Lamotrigine
    • Topiramate
  • Atonic
    • Valproate