Status Epilepticus Severity Score (STESS)
Status Epilepticus Severity Score (STESS). Predicts in-hospital mortality and functional outcome in status epilepticus. Helps identify patients requiring ICU vs ward-level management.
Score interpretation
→ STESS 0–2: Good prognosis. In-hospital mortality <5%. Treat status epilepticus per protocol (lorazepam IV, then levetiracetam/valproate if not resolved); EEG monitoring; neurology review; identify and treat precipitant.
→ STESS 3–4: Intermediate prognosis. ICU admission likely required; continuous EEG monitoring; antiepileptic optimisation; anaesthetic agent consideration (propofol/midazolam infusion) if refractory; treat underlying cause.
→ STESS 5–6: Poor prognosis; in-hospital mortality >30%. ICU; refractory SE protocol; continuous EEG; consider ketamine/barbiturate anaesthesia; urgent neuroimaging; early goals-of-care discussion with family.
Interpretation bands for the STESS Score. Apply clinical judgement and local guidance.
References
Related
Curated clinical cross-links plus same-class fallbacks.
- Phenytoin / Fosphenytoin · Antiepileptic — Status Epilepticus (Second-Line)
- Levetiracetam (IV) · Antiepileptic — Status Epilepticus (Second-Line)
- Levetiracetam IV (Status Epilepticus) · Antiepileptic — Second-Line Status Epilepticus
- Diazepam (Paediatric) · Benzodiazepine — Status Epilepticus / Febrile Convulsions (Community)
- Midazolam (Paediatric) · Benzodiazepine — Status Epilepticus (First-Line) / Procedural Sedation
- Ranolazine · Refractory Stable Angina
- Acute Stroke / TIA Assessment · NICE NG128; RCP Stroke Guidelines 2023
- Status Epilepticus (Adults) · NICE CG137; ESEM guidelines; RCP Neurology Guidelines
- Suspected Subarachnoid Haemorrhage · NICE NG228; RCEM 2023; AHA/ASA 2023
- Adult Head Injury · NICE NG232 (2023)
- Bell's Palsy / Facial Nerve Palsy · ENT UK 2017; AAN
- Vertigo Workup · ENT UK; NICE CKS
Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.