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A prolonged seizure with unconsciousness is a life-threatening emergency situation requiring immediate care. An epileptic seizure lasting for more than 5 minutes should be treated as an imminent status epilepticus. Mortality and the risk of disability increase when a seizure with unconsciousness has lasted for more than 30 minutes. The prognosis can be influenced by early treatment that is as effective as possible. Status epilepticus (SE) requires follow-up at hospital and aetiological investigations (brain imaging studies, cerebrospinal fluid samples, additional laboratory investigations), as well as treatment even after the acute situation has settled. When a patient with known epilepsy has had a prolonged seizure it is usually warranted to consider intensification of the basic medication and other possible measures by a neurologist.