Status Epilepticus

A convulsion that continues past five minutes is no longer a watch-and-wait event. Treat ongoing generalized convulsive activity as status epilepticus while simultaneously protecting oxygenation, checking glucose and preparing time-dependent medication therapy. The treatment clock matters because prolonged seizure activity progressively injures neurons and makes benzodiazepines less effective. The practical sequence is simple: stabilize during the first 0–5 minutes, give a full-dose benzodiazepine at 5 minutes, move to a second-line intravenous antiseizure medication if activity continues after adequate benzodiazepine therapy, and escalate to ICU anaesthetic treatment with continuous EEG when status becomes refractory. Stopping the visible movements is not enough; the patient must also regain consciousness as expected.