In this episode, Sam Ashoo, MD and T.R. Eckler, MD discuss the September 2025 Emergency Medicine Practice article, Emergency Department Management of Patients With Status Epilepticus

Topic Introduction

Why Status Epilepticus Matters

Guidelines and Evidence

Review of major guidelines (International League Against Epilepsy, Neurocritical Care Society, American Epilepsy Society)
Key trials: EcLiPSE, ConSEPT, ESETT
Updated definition of status epilepticus

Classification and Diagnosis

Etiology and Workup

Prehospital and ED Management

Diagnostics

Treatment Approach

First-line: Benzodiazepines (lorazepam, midazolam)
Second-line: Levetiracetam, valproate, fosphenytoin, phenobarbital, lacosamide
Third-line: Continuous infusions (midazolam, propofol, pentobarbital, thiopental, ketamine)
Dosing pearls and importance of rapid escalation

Special Populations

Risk Management Pitfalls

Clinical Pathway

Conclusion

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Adult Status Epilepticus

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