What monitoring and follow-up should be implemented for a patient recovering from status epilepticus?

After a patient recovers from status epilepticus, monitoring and follow-up should include urgent specialist assessment to evaluate seizure control and underlying causes, ideally within 2 weeks of the event.

Provide information to the patient and their family about recognising further seizures, first aid, and safety measures to reduce risk of recurrence.

Perform a detailed clinical assessment including history, physical examination, and if possible, eyewitness accounts or video footage of the seizure.

Conduct a 12-lead ECG to exclude cardiac causes that may mimic seizures.

Offer brain neuroimaging, preferably MRI following epilepsy protocols, to identify structural causes.

Consider EEG as soon as possible (ideally within 72 hours) to support diagnosis and guide management.

Assess and address modifiable risk factors such as mental health problems, vascular risks, or infections that may increase seizure recurrence risk.

Arrange ongoing follow-up to monitor seizure control, medication adherence, and to consider further interventions such as epilepsy surgery or vagus nerve stimulation if seizures remain drug-resistant.

Ensure communication and shared decision-making with the patient and carers throughout the follow-up process.

This comprehensive approach aims to reduce the risk of further seizures and optimize long-term outcomes after status epilepticus.