Modern concepts of status epilepticus.

Among 60 cases of status epilepticus, there were 45 cases of convulsive status and 15 cases of nonconvulsive or confusional status. In 37 cases, status was due to an identifiable cause. The most frequent etiologic factors were vascular (nine cases), traumatic (seven cases), and metabolic (five cases). Four patients with metabolic encephalopathy had focal status. While the possibility of expanding lesions should be investigated in every case of convulsive status, a complete metabolic screening is also necessary. Non-convulsive status was represented by two cases of psychomotor status and 13 cases of absence status. Clinically, these cases were characterized by various impairments of intellectual functioning and confusion. Diagnosis was determined by characteristic changes in the electroencephalogram. Aggressive treatment is indicated by one or more of the major anticonvulsants, supplemented by adequate oxygenation and maintenance of biochemical homeostasis.