Epileptic emergencies in adult patients Volume 19, issue 4, Octobre, Novembre, Décembre 2007

Service de neurologie et unité fonctionnelle d’épileptologie, Hôpital Pasteur, 30 Voie Romaine, 06002 Nice, France

Convulsive status epilepticus is a major medical emergency. Prompt and effective treatment is requested to prevent death or neurological sequelae. First-line drugs must have a favourable benefit/risk ratio. Refractory status epilepticus must be treated aggressively by second-line sedative drugs. In this situation, EEG monitoring must diagnose subtle status epilepticus by controlling the disappearance of ictal discharges. Non-convulsive generalized or partial status epilepticus is a diagnostic challenge, best solved by emergency EEG. Immediate discontinuation of antiepileptic drugs is requested to avoid potentially serious idiosyncratic side-effects. Electroencephalographic status epilepticus in coma must be differentiated from non convulsive status epilepticus occuring in ambulatory patients. Prescriptions habits will be avoided to prevent recurrence of isolated convulsive seizures.