Status epilepticus: a plan for management.

Status epilepticus of the generalized tonic-clonic form is a serious, life-threatening neurological emergency. Management must be swift and effective to protect the brain from anoxic damage and serious neurological sequelae. Most cases are due to withdrawal or non-compliance with anticonvulsant medication in known epileptics. Diazepam, phenytoin and phenobartital are effective in stopping these episodes. Other drugs may be effective in certain individuals, but most appear to work with `hit or miss' effectiveness. Barbiturate anesthesia is an effective method of ending status epilepticus episodes when the primary agents have failed, and this step should be undertaken early in the management of resistant cases.