Causes, manifestations, and complications of generalized convulsive status epilepticus in adults

Generalized convulsive status epilepticus (GCSE) represents the most clinically dramatic and life-threatening type of status epilepticus, characterized either by continuous generalized tonic–clonic convulsive seizures or by repetitive bilateral convulsive seizures without recovery to functional baseline in the interictal periods. Although GCSE can emerge from partial seizures or partial status epilepticus, and the convulsions typically decrease by frequency and intensity over time, the widespread clonic movements represent the pathognomonic clinical feature of GCSE. Despite highly advanced neurointensive care, complications and mortality of GCSE remain high. An understanding of the underlying causes, the clinical manifestations, and the immediate systemic and neurologic consequences of GCSE are keys for optimal treatment. This chapter will discuss the epidemiology, classification, and etiologies of GCSE in adults along with acute systemic and neurologic consequences, and recommendations for optimal neurointensive care.