Status Epilepticus: Do Treatment Guidelines Make Sense?

Status epilepticus represents an acute, potentially life-threatening emergency with considerable risks of morbidity and mortality, mainly depending on age at onset, underlying etiology, seizure severity, and medical comorbidities. Recent European and North American guidelines on management and treatment of status epilepticus strongly recommend prompt treatment to prevent further complications. At present, following a staged treatment protocol is recommended. Benzodiazepines are the treatment of choice in early status epilepticus, but there are no class I data supporting treatment recommendations on the choice of antiepileptic drugs for established and refractory status epilepticus. This article reviews advantages and potential drawbacks of the available guidelines.