Time Is Brain

Status epilepticus (SE) is a life-threatening emergency that requires prompt recognition and treatment and is common in the ICU. The definition of SE has evolved, with a shift toward highlighting the potential for permanent neurologic injury and prioritizing early termination. Although EEG serves a confirmatory role in the diagnosis of convulsive SE, SE in the ICU often is nonconvulsive, making EEG essential for diagnosis and management. In this review, we characterize the neurobiology of SE and provide clinically applicable strategies for timely recognition and effective treatment of SE, highlighting ICU-level therapies and integration of continuous EEG. We also discuss the simultaneous etiologic evaluation that must take place to identify the cause of SE.