To develop expert consensus recommendations for the outpatient management of certain prolonged seizures (PS) and seizure clusters (SC) to prevent progression to more severe seizure types or seizure emergencies. 

Consensus was reached on which patients with specific seizure types warrant REST, and on advice to patients/caregivers regarding when to administer outpatient treatment. All experts agreed that all patients who have experienced PS should be offered REST medication, and all who have experienced SC should be offered medication to prevent subsequent seizures. When prescribing outpatient medication, a seizure action plan should be agreed in consultation with patients/caregivers. All experts agreed that for patients whose main seizure pattern is SC, medication to prevent subsequent seizures should be considered at first seizure onset, and 11/12 agreed that patients with a history of PS and recognizable pattern of onset should administer REST medication as early as possible.

High levels of agreement were reached on recommendations for seizure types warranting treatment to terminate ongoing seizures/seizure clusters as rapidly as possible, and on advice for patients/caregivers regarding when to use outpatient medications. These expert consensus recommendations will provide clearer guidance to clinicians, patients and caregivers, and aid establishment of REST as a new paradigm for prolonged seizure management.