Rationale: Status Epilepticus (SE) is a severe neurologic condition with significant morbidity and mortality. Generalized convulsive status epilepticus consists of a self-perpetuating generalized tonic-clonic seizure or a series of generalized tonic-clonic seizures without return to consciousness in between seizures. Treatment of GCSE should proceed without delay, as early treatment is associated with better response and outcome. There is a gap between SE management in urban hospital emergency room (ER) and practice guidelines. Methods: This was a retrospective chart review of patients presenting with status epilepticus to the University Hospital emergency room in Newark NJ
. Patients >18 years, presenting with status epilepticus from July 1
st 2010 to June 30
th 2013 were analyzed. Results:
87 patients (47 males and 40 females) were analyzed. 10 of these patients had multiple ER visits and total number of cases was 101. Ninety-six of these patients had convulsive status (88 generalized convulsive status and 8 focal status) and five patients had non-convulsive status. 38% patients had prior history of epilepsy and 62% were new-onset seizures. Most common etiology was non-compliance (25%), followed by metabolic abnormality (13%), infection (13%), intracerebral bleed or SAH (12%), alcohol related (5%), posterior reversible encephalopathy syndrome (4%) and unknown (5%). 85% SE patients received benzodiazepines within 5 minutes and only 42% of these patients received lorazepam >=4mg IV. The second line of treatment was: 64% received phenytoin/fosphenytoin loading, 10% levetiracetam loading, 3% valproate loading, 1% phenopharbital, 10% propofol drip. 12% patients received no 2nd line anti-epileptic drug when SE was controlled by benzodiazepines. All patient received neurology consult, but only 34% neurology consults were called within 10 minutes of ER arrival. SE patients who were seen by neurologist within 10 min had shorter average shorter length of stay (7.5 days vs. 11.3 days, P<0.05) and better outcome, compared with patients seen by neurologist later.