Recommendations for the management of urgent epileptic seizures and status epilepticus: Colombian expert consensus: consenso colombiano de expertos

Introduction: Isolated high-risk epileptic seizures, seizure clusters, and status epilepticus are encompassed under the concept of urgent epileptic seizures. This clinical situation is highly prevalent and has a negative impact on the morbidity and mortality of patients. Rapid and appropriate treatment is one of the most important prognostic factors for improving the functional outcome of these patients. Materials and methods: A working group was formed with 11 experts in epilepsy and emergency medicine, guided by an international expert. Recommendations for managing urgent epileptic seizures were developed based on information obtained from a systematic literature review (2014-2024). The findings were evaluated using the Delphi methodology, establishing an acceptance threshold with a median of 9 (interquartile range <1.5), and allowing members to vote on and discuss the recommendations. An academic meeting facilitated a detailed analysis and the development of the final consensus. Results: The results of this consensus are grouped into six subtypes of recommendations covering: definition of concepts, initial treatment of urgent epileptic seizures, treatment of isolated high-risk epileptic seizures, treatment of seizure clusters, treatment of motor status epilepticus, and other recommendations. Conclusions: In patients with urgent epileptic seizures, the variable that most influences the functional prognosis is the speed of treatment initiation. Therefore, the expert consensus recommends providing rapid and organized treatment. This treatment should be individualized based on the clinical scenario and the specific comorbidities of each patient.