Definition: Persistent status epilepticus is an abnormally long (t1) epileptic seizure due to a failure of the mechanism that terminated the seizure or a new epileptogenic mechanism. This event has the potential to cause long-term damage to the brain (seizure duration beyond t2), and possible injuries include: neuronal death, neuronal damage, and neuronal network changes. Depending on the type of seizure and the duration of the seizure, the damage may vary. t1 (time 1): By this time, epileptic seizures are likely to persist. t2 (time 2): Long-term damage (i.e., neuronal death as listed above or something) is likely to occur. If the epileptic seizures are not under control, change the medication. Why did you go around for so long and just don’t say the exact minutes pinch? It’s because it’s not that simple. The first thing you need to do is to take a look at the results of the study. Experts also do not have so much evidence. The article is appreciated because it is super objective and constantly emphasizes that the specific time point is only based on the current clinical and animal experimental findings, and will be updated immediately if there are new developments. Still, it’s a good framework for the concept, and it’s okay not to move around. Having set the time is only the first step in diagnosis. Next, we have to refine the information on four aspects of persistent epilepsy: 1. clinical manifestations, signs and symptoms. 2, etiology. 3. electroencephalogram. 4, age. When we talked about t2, we were a little less critical about the medication change, so here is the 2012 Neurocritical Care Association’s treatment process recommendations. The experts in this article blurred the time criteria for refractory status epilepticus, saying only that it can be defined as refractory status epilepticus when two antiepileptic drugs are ineffective. However, when converted, they recommend starting benzodiazepines (diazepam is most commonly used in China, and midazolam can also be used intramuscularly. The most important thing is that the patient should be able to take care of his or her own health. According to the principle of counting here, almost half an hour, if it is still not controlled, it is time to change. As for the choice of medication for refractory status epilepticus later, it is more similar to the past (you can refer to the domestic guidelines) without further elaboration.