Semin Neurol 2024; 44(03): 324-332
DOI: 10.1055/s-0044-1785503
Review Article

Status Epilepticus: An Update on Pharmacological Management

Sulaiman Almohaish
1   Department of Pharmacy Practice, Clinical Pharmacy College, King Faisal University, Al-Ahsa, Saudi Arabia
Eljim P. Tesoro
2   Department of Pharmacy Practice, University of Illinois at Chicago College of Pharmacy, Chicago, Illinois
Gretchen M. Brophy
3   Department of Pharmacotherapy and Outcomes Science, School of Pharmacy, Virginia Commonwealth University, Richmond, Virginia
› Author Affiliations


Status epilepticus (SE) is a neurological emergency that requires timely pharmacological therapy to cease seizure activity. The treatment approach varies based on the time and the treatment stage of SE. Benzodiazepines are considered the first-line therapy during the emergent treatment phase of SE. Antiseizure medicines such as phenytoin, valproic acid, and levetiracetam are recommended during the urgent treatment phase. These drugs appear to have a similar safety and efficacy profile, and individualized therapy should be chosen based on patient characteristics. Midazolam, propofol, pentobarbital, and ketamine are continuous intravenous infusions of anesthetic medications utilized in the refractory SE (RSE) period. The most efficacious pharmacotherapeutic treatments for RSE and superrefractory status epilepticus are not clearly defined.

Publication History

Article published online:
05 April 2024

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