In this episode, we explore the urgent management of convulsive status epilepticus, focusing on the efficacy and safety of anticonvulsant medications. We review first-line benzodiazepine therapy and examine second-line options—including fosphenytoin, phenytoin, levetiracetam, and valproate—with insights from the ESETT trial showing similar effectiveness among them. We also discuss the emerging role of ketamine for refractory cases, highlighting its unique mechanism and neuroprotective potential. Join us as we emphasize the importance of rapid, effective treatment to reduce neuronal injury and improve outcomes.