Case-Based Modules > Case 15 > Conclusion

Great job! This wasn't necessarily a difficult case, but it did require some nuance in appreciating that not all focal status epilepticus is equal.

Pearl 1: When told that a patient is in focal status epilepticus, your first question should be: how is the patient's mentation?

If their mentation is poor, then it's focal status with impaired awareness, and you should treat as you would any other status epilepticus case, eventually escalating to intubation and sedation if needed. Otherwise, if their mentation is preserved, then it's focal status with preserved awareness, and you can treat with benzodiazepines and ASMs to try to stop it. However, you should be careful so as to not oversedate them and give them a reason to get intubated, when it can be otherwise avoided.

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