Evidence is scarce regarding the treatment of status epilepticus (SE). Only a few large randomized controlled trials have been published. Therefore, we set up a multicenter registry to prospectively document treatment practice in several different large hospitals in German-speaking countries. Over a period of more than 4 years, we were able to document 1179 episodes of 1049 patients who were treated for SE in 1 of the 8 participating centers in Germany, Austria, and Switzerland. Median age was 70 years. The most frequent etiology was remote (32%), followed by acute (31%), or a mixture of acute and remote factors (10%). Semiology was generalized convulsive in 44%, focal motor in 27%, and nonconvulsive in 30%. Only a few patients did not have relevant comorbidities. Median latency between SE onset and first treatment was 1 hour (median). Three hundred ninety-three (32%) of the patients were treated within 30 minutes after onset. The first treatment step consisted of benzodiazepines in more than 80%, and in levetiracetam in 15%. Five hundred eleven patients (49%) were refractory (defined as ongoing SE after application of benzodiazepine and 1 intravenous anticonvulsant). Further analysis of these registry data may be important for hypothesis generation and trial design for treatment of status epilepticus.
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