Status epilepticus can assume as many forms as there are varieties of epileptic seizures.

—Gastaut, 1967

Introduction

The subdivision of focal seizures into simple partial seizures and complex partial seizures was adopted by the Commission on Classification and Terminology of the International League Against Epilepsy in 1981 (42). These terms were applied to status epilepticus (SE) by Gastaut in 1983 (72), with alteration of consciousness used to differentiate elementary or simple partial status epilepticus (SPSE) from complex partial status epilepticus (CPSE). Although Shorvon has recently attempted a syndromic classification of SE (191) that takes into account age, cerebral maturation, and pathophysiologic mechanisms, there is no recognized alternative to the dichotomy of simple versus complex based on altered consciousness. This chapter therefore follows the existing classification, although two types of problems are associated with it. The first is that SE of different types cannot in fact be reduced to the types of seizures of which they are composed, but are distinct clinical entities, which may be very different from the seizure types to which their names refer. The second is that a separation of SE into two large categories based exclusively on alteration of consciousness does not appear justified on any pathophysiologic, anatomic, or prognostic ground, resulting in forms of ambiguous classification such as nonconvulsive SE of frontal origin or aphasic SE. Alteration of consciousness is also notoriously difficult to define and therefore to evaluate clinically (79).