Acute symptomatic seizures (ASS) are the seizures of different etiology that occur in close temporary relationship to acute damage of the central nervous system arising simultaneously due to metabolic, toxic, infectious and inflammatory factors and structural brain damage. At the time of its origin, ASS is often not distinguished from epileptic seizures in the clinical and electrophysiological parameters, although represent a fundamentally different state from the point of view of pathogenesis, therapy and prognosis. Tactics in the ASS and symptomatic epileptic status of any nature provides for the immediate carrying out differential diagnosis and differential treatment. Treatment of ASS includes two aspects: reduction in ictal activity (seizures) and prevention of future development of seizures through the elimination or correction of physiological trigger of the attacks and the decision to conduct a long-term antiepileptic drug therapy if the risk of seizures is saved.