History of Status Epilepticus

Abstract

The earliest references to ongoing seizure activity or status epilepticus appear in cuneiform, biblical, Roman, and Medieval sources. Prior to the use of EEG, written accounts centered on the behavioral changes and confusion (particularly with nonconvulsive states), which because of their proximity to convulsive seizures, were often inferred to reflect ongoing epileptic activity. Most clinical descriptions in the nineteenth and twentieth centuries emerged from neurological observations being made in England, France, and Germany. A clearer understanding of the types of status epilepticus arose from clinical-EEG correlations beginning in the 1940s and 1950s, and observations from prolonged cine or video-EEG monitoring in epilepsy monitoring units and intensive care units over the last 40 years. There has been an increasing understanding that clinical outcome largely depends on the etiology of the status epilepticus. With the development of parenteral anti-seizure drugs, benzodiazepines, and anesthetic agents, and the improved supportive care measures available in ICUs, the morbidity and mortality from status epilepticus have fallen over the past 50 years, and newer therapeutic approaches and diagnostic methods continue to emerge.