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 GGC guideline. 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.
The treatment pathway of convulsive status epilepticus (stage 1-3), as well as the choice of antiepileptic drug, are outlined here. More detail regarding choice, dosage and administration of antiepileptic drugs can be found by following the relevant links below:
Once seizures are controlled see the full GGC guideline, which can be found here, for ongoing management.
Guideline reviewed: June 2022
Page updated: September 2023