Module 3: Assessment

Lesson 6

Learning outcome

Describe the epidemiology, comprehensive assessment, safety considerations and goals of care that need to be addressed in prescribing therapy for status epilepticus.


Status epilepticus, a prolonged seizure crisis and relatively common neurological emergency, is discussed in relation to the prescription of controlled drugs and substances.

Definition of status epilepticus

Status epilepticus (SE) is defined as more than 30 minutes of prolonged seizure crisis involving either:

  • continuous seizure activity
  • two or more seizures in sequence without regaining full consciousness between seizures

Most seizures last 1–2 minutes. Given the high mortality rate associated with late intervention, treatment protocols recommend intervention after 5 minutes of continuous seizure activity. Status epilepticus can be classified by electrical activity (semiology), underlying etiology and the duration of the seizure.

There are three main etiological sources of SE:

  • Exacerbation of a pre-existing seizure disorder
  • First occurrence of a seizure disorder
  • Other insults outside of a seizure disorder

The characteristics of the three Status Epilepticus states are outlined below:

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