Patient presented with status epilepticus, a prolonged seizure activity lasting greater than five minutes or involving recurrent seizures without recovery of consciousness between events.  The patient exhibited tonic-clonic seizure activity characterized by generalized convulsions with rhythmic jerking movements and loss of awareness.  Onset of seizure activity was witnessed by family and reported as abrupt.  Prior to the event, the patient reported no prodromal symptoms such as aura or headache.  Medical history significant for epilepsy diagnosed two years prior, currently managed with levetiracetam.  Medication compliance was questioned and patient reported inconsistent adherence to prescribed regimen.  Initial assessment revealed altered mental status, postictal confusion, and oxygen saturation of 92% on room air.  Intravenous access was established and the patient was administered lorazepam followed by a loading dose of fosphenytoin per protocol for status epilepticus management.  Continuous electroencephalogram (EEG) monitoring was initiated to assess ongoing seizure activity.  Subsequent neurological examination revealed no focal deficits.  Differential diagnosis included  non-epileptic seizures, syncope, and metabolic disturbances.  Laboratory studies including complete blood count (CBC), comprehensive metabolic panel (CMP), and serum toxicology were ordered to evaluate for underlying causes.  Patient responded to treatment with cessation of seizure activity and gradual return to baseline neurological status.  The patient was admitted for further observation and management of epilepsy, including medication reconciliation and adjustment.  Diagnosis: Status epilepticus, generalized tonic-clonic seizures, uncontrolled epilepsy.  Plan includes continued EEG monitoring, initiation of maintenance antiepileptic drug therapy, and patient education regarding medication adherence, seizure triggers, and epilepsy management.