Therapy of incipient and established status epilepticus

Status epilepticus (SE) is one of the major neurological emergency situations requiring immediate medical treatment and is associated with substantial mortality and morbidity. The incidence of SE increases with age so that an increasing incidence of SE is to be expected due to the rising age of the population. The nationwide annual inpatient treatment costs of SE in Germany are estimated to be more than 80 million (sic). Currently a multitude of anticonvulsive substances are available for therapy of the various status forms which are used in very different therapy regimens. This article discusses the current initial therapy (treatment stage 1) and the treatment of established SE (treatment stage 2) on the basis of the S2k guidelines 2012 of the German Society of Neurology (DGN 2012). Both these initial therapy stages result in a breakthrough of SE in 20-80 % of cases depending on the duration of SE before therapy and the etiology of the response rate.