The American Epilepsy Society (AES), a large epilepsy research and education body in the US, has developed a new set of guidelines to establish more effective procedures for the treatment of prolonged and serious seizures in people with epilepsy.The guidelines were prompted by the results of a large review of all available adult and paediatric evidence, and they aim to ensure that future cases of status epilepticus are managed in the best possible way.Published in the medical journal Epilepsy Currents, the guidance aims to address the variation in treatment approaches when it comes to status epilepticus, which is defined as a seizure or series of seizures (without the regaining of consciousness in between) lasting for five minutes or more.It is widely recognised that status epilepticus represents a medical emergency, and that there are high mortality and brain damage risks associated with seizures that last for 30 minutes or more. However, until now there has been no strong consensus on the best way to manage it.The AES guidance recommends that the first five minutes of seizure activity should be dedicated to stabilisation, standard first aid and basic monitoring, and that benzodiazepine therapy such as midazolam, lorazepam or diazepam should be administered if it lasts between five and 20 minutes.For incidents lasting between 20 and 40 minutes without response to initial treatment, the drugs fosphenytoin, valproic acid and levetiracetam are highlighted as possible options, and for cases that last longer than this, a repeat dose of these therapies is suggested, or anaesthetic doses of thiopental, midazolam, pentobarbital or propofol.It is hoped that these guidelines will help doctors treat status epilepticus in a more structured way, thereby minimising the risk of significant damage to those affected.Guideline author Dr Tracy Glauser, at the Cincinnati Children’s Hospital Medical Center’s Comprehensive Epilepsy Center, said: “This is a valuable new guideline for both children and adults that could change the approach many clinicians take in treating these seizure emergencies. The goal of therapy is the rapid termination of the seizure activity to reduce neurological injuries and deaths.”Click here for more articles about anti-epileptic drugs and pregnancy risks.