To the Editor.
—As a practicing neurologist, I found the article by the Working Group on Status Epilepticus1 valuable and detailed. However, I must comment on the recommendation that the decision to initiate long-term therapy should be individualized. The authors state that anticonvulsant treatment is prescribed by many neurologists following status epilepticus, though the decision is not supported by epidemiologic data.Epidemiologic data on recurrence of seizures depends on the likelihood that patients will report further seizures. Patients may avoid reporting seizures for several reasons (eg, loss of driver's license, fear of restrictions on other activities, or fear that more medication will be prescribed); therefore, existing data on how many patients who experience status epilepticus will have further seizures later in life are suspect. Underreporting seizures is likely. The epidemiologic data may not be definitive from this viewpoint.A crucial consideration is the likelihood that the patient will sustain
Fellman DM. Treatment of Status Epilepticus. JAMA. 1994;271(13):980-981. doi:10.1001/jama.1994.03510370032016