Antiepileptic Drug Therapy for Status Epilepticus. 2021

Daeyoung Kim, and Jae Moon Kim, and Yong Won Cho, and Kwang Ik Yang, and Dong Wook Kim, and Soon Tae Lee, and Young Joo No, and Jong Geun Seo, and Jung Ick Byun, and Kyung Wook Kang, and Keun Tae Kim, and
Department of Neurology, Chungnam National University Hospital, Chungnam National University College of Medicine, Daejeon, Korea.

Status epilepticus (SE) is one of the most serious neurologic emergencies. SE is a condition that encompasses a broad range of semiologic subtypes and heterogeneous etiologies. The treatment of SE primarily involves the management of the underlying etiology and the use of antiepileptic drug therapy to rapidly terminate seizure activities. The Drug Committee of the Korean Epilepsy Society performed a review of existing guidelines and literature with the aim of providing practical recommendations for antiepileptic drug therapy. This article is one of a series of review articles by the Drug Committee and it summarizes staged antiepileptic drug therapy for SE. While evidence of good quality supports the use of benzodiazepines as the first-line treatment of SE, such evidence informing the administration of second- or third-line treatments is lacking; hence, the recommendations presented herein concerning the treatment of established and refractory SE are based on case series and expert opinions. The choice of antiepileptic drugs in each stage should consider the characteristics and circumstances of each patient, as well as their estimated benefit and risk to them. In tandem with the antiepileptic drug therapy, careful searching for and treatment of the underlying etiology are required.

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