The role of the newer antiepileptic drugs in the treatment of generalized convulsive status epilepticus

The emergency treatment of seizures is an important practical issue, especially the treatment of generalized convulsive status epilepticus (GCSE). Benzodiazepines or older standard antiepileptic drugs (phenobarbital, phenytoin) have typically been used as initial intravenous treatment of GCSE. As new parenteral antiepileptic drugs are developed, and more are on the horizon, questions are raised regarding their role in the treatment of status epilepticus (SE). This review discusses the evidence for the treatment of GCSE, including the newer agents (valproate, levetiracetam). We correlate the treatment of SE with our modern understanding of the underlying neurophysiology and seizure duration.