Convulsive status epilepticus (continuing or recurrent seizures over 5 minutes, or without recovery) is a medical emergency with a 16–39% mortality rate. There is a risk that seizures will cause cerebral damage if not controlled within 30 minutes of onset.
This guideline contains brief guidance on the management of convulsive status epilepticus stages 1 -3 (the first 30minutes) in adults who are ≥16 years old and not pregnant. Further information, including ongoing management once seizures are controlled, is available in the full guideline on AthenA / Guidelines - Prescribing. The guidance is based on the SIGN guideline for diagnosis and management of epilepsy in adults and up-to-date trial information. Treatment may differ in individual clinical circumstances. If your patient is pregnant, consult specialist guidelines for advice.
For the treatment pathway of convulsive status epilepticus (stages 1-3), as well as the choice of antiepileptic drug:
More detail regarding choice, dosage and administration of antiepileptic drugs can be found by following the relevant links below:
Once seizures are controlled, follow guidance for ongoing management here.
N.B. The full guideline can be found on AthenA / Guidelines - Prescribing.
Guideline reviewed: August 2022 (minor update October 2024)
Page updated: November 2024