SE is a neurological emergency known to be related to high morbidity and mortality and requires prompt termination. It is important to evaluate the effectiveness of the current treatment for SE to improve patient care.  

49 patients had and were treated for 64 incidences of convulsive or nonconvulsive SE recorded on cvEEG or clinical seizures longer than 5 min which were documented by a neurologist. Among 64 cases, 55 incidences required the second antiepileptic drug (AED), and 40 out of 55 cases were treated with the third AED subsequently. The mean seizure detection-to-needle time for the first, second, and third AEDs were 167, 239, and 297 minutes, respectively. Benzodiazepines were administered as the first AED in only 46 % of all treated cases. The duration of the hospital stays in patients treated with the first AED within 60 min after seizure detection was shorter compared to those whose treatment was delayed (23.0 vs. 33.6 days, p=0.41). The mortality rate in the former group was lower than that in the group which did not receive AEDs within 60 min (28.6 vs. 53.6%, p=0.02). 

The current treatment for SE at UNMC is inefficient with significant delay in delivery of medications after seizure detection; it may contribute to the prolonged hospital stay and increased mortality. In order to improve patient care, a protocol for the efficient treatment of SE must be established.