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Background <p>Status epilepticus (SE) is a&#xa0;neurological emergency that, if left untreated, can lead to irreversible brain damage or death. The treatment follows a&#xa0;structured stepwise protocol, with benzodiazepines as the first choice, followed by additional seizure suppressants in cases of refractory SE. Early initiation and correct dosing are crucial.</p> Objective <p>This paper examines the current treatment recommendations for SE and the implementation of these guidelines in clinical and preclinical care. The focus is on the importance of rapid medication administration and the challenges posed by regional differences in healthcare provision.</p> Results <p>Studies show that the rapid administration of benzodiazepines (e.g. lorazepam, midazolam) required by the guidelines is too often not carried out in the first phase of treatment.</p> Discussion <p>Prompt and appropriate treatment of SE is crucial to prevent neurological damage or death. In preclinical care, problems often arise due to underdosing and insufficient availability of antiseizure medications. Different regional healthcare structures lead to varying treatment approaches. Preclinical care needs to be further standardized, and portable EEG devices could aid in the early diagnosis of nonconvulsive SE.</p>

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Prehospital treatment of seizure clusters and status epilepticus. English version

  • 期刊论文

  • 发表日期：

    2025年12月18日

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  • Clara Jünemann,
  • Christian Claudi,
  • Philipp Bücke,
  • Nils G. Margraf,
  • Leona Möller

摘要

Background

Status epilepticus (SE) is a neurological emergency that, if left untreated, can lead to irreversible brain damage or death. The treatment follows a structured stepwise protocol, with benzodiazepines as the first choice, followed by additional seizure suppressants in cases of refractory SE. Early initiation and correct dosing are crucial.

Objective

This paper examines the current treatment recommendations for SE and the implementation of these guidelines in clinical and preclinical care. The focus is on the importance of rapid medication administration and the challenges posed by regional differences in healthcare provision.

Results

Studies show that the rapid administration of benzodiazepines (e.g. lorazepam, midazolam) required by the guidelines is too often not carried out in the first phase of treatment.

Discussion

Prompt and appropriate treatment of SE is crucial to prevent neurological damage or death. In preclinical care, problems often arise due to underdosing and insufficient availability of antiseizure medications. Different regional healthcare structures lead to varying treatment approaches. Preclinical care needs to be further standardized, and portable EEG devices could aid in the early diagnosis of nonconvulsive SE.