Status Epilepticus Note Template & Plan
A status epilepticus note builder for residents: pick the stage, enter weight and what has been given; the escalation plan and cEEG targets write themselves.
Reviewed by Zaka Ahmed, MD Clinical reference · 4 min read
Status Epilepticus Note Builder
⚠ Do not enter names, dates of birth, MRNs, or any other identifier. Nothing is stored on our servers.Educational documentation aid for clinicians. It applies published guideline logic to what you enter; it does not know your patient. Verify every line, follow your institutional protocol, and use clinical judgment. Full disclaimer. All builders in one place: the residents’ workspace.
Assistant (beta)
Type or dictate your one-line impression and the assistant fills the fields above; the plan itself still comes from the rule set, not from the model. No identifiers — the text goes to our own server and on to a language-model provider, and is not stored.
My phrases — the builder learns your service
Add the lines your attending always wants. Saved in this browser only and appended to the section you choose every time you build this note.
Clinical notes & interpretation Scoring guidance, pitfalls, FAQs, and references
Status epilepticus is treated on a clock; the note should read like one.
- → Pick the stage — early, established, refractory, super-refractory, or controlled — and the builder writes the next step, with weight-based doses when you enter a weight (lorazepam 0.1 mg/kg, levetiracetam 60 mg/kg, valproate 40 mg/kg, fosphenytoin 20 PE/kg).
- → It calls out the commonest error — an underdosed benzodiazepine — and asks for continuous EEG whenever the patient is not back to baseline within an hour.
- → The etiology section adapts: LP and empiric acyclovir when infection is possible, the NORSE workup for new-onset refractory status, reloading for nonadherence.
Staged, not improvised
The ESETT trial showed levetiracetam, fosphenytoin, and valproate are equivalent as second-line agents, so the builder writes all three with the comorbidity that steers the choice, and it insists the second-line agent be given immediately rather than after a wait. For refractory status it writes intubation and a continuous anesthetic (midazolam or propofol) with early ketamine, the burst-suppression target and duration, and the wean under continuous EEG.
The lines residents forget at 3 a.m.
Thiamine before dextrose. Antiseizure-medication levels and a toxicology screen. Adding a maintenance agent with a different mechanism so the anesthetic can later be weaned onto something. Triglycerides, CK, and lactate on propofol. The benzodiazepine-trial approach to the ictal–interictal continuum so periodic discharges are not over-treated with anesthetics. Each is a generated line.
Non-convulsive status
If you mark the seizure type as non-convulsive, the builder still applies the same staged escalation but keeps the EEG-driven decisions front and center, since clinical signs are absent by definition.
Frequently asked questions
Where do the doses in this note come from?
From the American Epilepsy Society 2016 guideline and the ESETT trial for first- and second-line therapy, and from the Neurocritical Care Society guidance for anesthetic infusions. The builder computes weight-based doses only when you enter a weight and applies published maximums; the numbers are a documentation aid, not an order set.
When does the builder ask for continuous EEG?
Whenever the patient is not back to neurologic baseline within about an hour of clinical control, whenever an anesthetic infusion is running, and whenever the type is non-convulsive. Roughly a fifth to a half of patients have ongoing electrographic seizures after convulsions stop.
What is NORSE and why does the note mention it?
New-onset refractory status epilepticus without a clear cause. When you mark no prior epilepsy and an unknown or autoimmune etiology, the builder adds the autoimmune-encephalitis workup, imaging for occult tumor, and the early immunotherapy discussion recommended by consensus guidance.
References
- Glauser T, et al. Evidence-based guideline: treatment of convulsive status epilepticus in children and adults (AES). Epilepsy Curr. 2016;16:48–61.
- Kapur J, et al. Randomized trial of three anticonvulsant medications for status epilepticus (ESETT). N Engl J Med. 2019;381:2103–2113.
- Brophy GM, et al. Guidelines for the evaluation and management of status epilepticus (NCS). Neurocrit Care. 2012;17:3–23.
- Wickstrom R, et al. International consensus recommendations for management of NORSE. Epilepsia. 2022;63:2827–2839.
Related reading
From the articles.
- First 24 hours after stroke Post-stroke seizures and early monitoring.