Generalized convulsive status epilepticus in adults and children: treatment guidelines and protocols

Emerg Med Clin North Am. 2011 Feb;29(1):51-64. doi: 10.1016/j.emc.2010.08.005.


Generalized convulsive status epilepticus (GCSE) has a high morbidity and mortality, such that the rapid delivery of anticonvulsant therapy should be initiated within minutes of seizure onset to prevent permanent neuronal damage. GCSE is not a specific disease but is a manifestation of either a primary central nervous system (CNS) insult or a systemic disorder with secondary CNS effects. It is mandatory to look for an underlying cause. First-line therapies for seizures and status epilepticus include the use of a benzodiazepine, followed by an infusion of a phenytoin with a possible role for intravenous valproate or phenobarbital. If these first-line medications fail to terminate the GCSE, treatment includes the continuous infusion of midazolam, pentobarbital, or propofol.

MeSH terms

  • Adult
  • Age Distribution
  • Algorithms
  • Anticonvulsants / therapeutic use*
  • Child
  • Child, Preschool
  • Critical Pathways
  • Emergency Service, Hospital
  • Humans
  • Incidence
  • Infant
  • Practice Guidelines as Topic*
  • Status Epilepticus / diagnosis
  • Status Epilepticus / drug therapy*
  • Status Epilepticus / epidemiology
  • United States / epidemiology


  • Anticonvulsants