Introduction

Generalized convulsive status epilepticus (GCSE) is a medical emergency (2, 18, 20). Rapid and effective treatment decreases brain injury and death (1, 2, 18, 20, 31, 32, 34). Delays in treatment increase morbidity and mortality and contribute to drug resistance (1, 2, 31, 32, 34). Exciting developments herald a new era in treatment: a new definition of SE, rectal diazepam for home, clinic, and institutional use, prehospital benzodiazepine infusion by paramedics, fosphenytoin as an alternative to phenytoin, and the growing use of alternative agents such as midazolam and propofol for refractory SE. This chapter reviews these new developments and relates the basic principles of treatment to the actual provision of care.