Status Epilepticus in Adults

In electroencephalography books, relative significance is given to “status epilepticus” (SE), maybe because of the idea that it could only be a simple repetition of seizures in a very short time from one another. Actually, at least two factors contribute making the EEG patterns of SE much more complex: the first is the overlapping of the transients related to the seizures with those related to underlying disease, and the second is the EEG modification related to a sustained or prolonged status epilepticus. The EEG of the SE can thus follow its graphic expression which is different from that of single seizures repeated over time, coming up to express critical patterns that are not always easily recognizable. The elements of pathophysiology and clinical electroencephalographic practice show that the SE is a dynamic pathological process that expresses itself in a different manner from patient to patient depending on its etiology, duration, topographic extension, clinical manifestation, and therapeutic interventions that are carried out. The proposed classification of SE in 2015 (Trinka et al., Epilepsia 56(10):1515–23, 2015) establishes the importance of EEG in the diagnosis and management of the SE by including the EEG axial description to define a correct classification of the patient.