This lecture will focus on three potentially genuine emergencies: Status epilepticus, Traumatic brain injury, and Acute spinal cord injury. Status epilepticus (SE) The basic pathophysiology of seizures and what happens when seizures fail to spontaneously resolve will be discussed briefly, before a more lengthy discussion on the potential local and systemic effects of SE. How to recognise SE, and why it is an emergency will be considered, alongside the patient assessment in the emergency situation as well as monitoring ion the longer term. Underlying aetiologies that may be behind a situation of SE will be explained. A strategy for controlling seizures in SE, as well as other important considerations for treating patients with SE will hopefully leave delegates feeling much more confident when faced with this distressing presentation. Traumatic brain injury The initial assessment of patients suspected of having suffered traumatic brain injury (TBI), including the use of the Modified Glasgow Coma Scale (MGCS) will be discussed, along with the limitations of the MGCS. A brief discussion of the pathophysiology of TBI alongside the causes and recognition of increased intracranial pressure (ICP) and the Cushing response, will lead into a more detailed explanation of potential treatment options and management strategies for TBI and elevated ICP. Acute spinal cord injury (SCI) The lecture will finish with a brief look at acute SCI, focussing on the potential causes, patient assessment and investigation, and prognosis in these difficult cases.