Pediatric refractory status epilepticus (RSE) and super refractory status epilepticus (SRSE) remain life-threatening disorders whose etiology and effective management are elusive according to a review in Seizure.
- RSE is defined as a disorder that doesn’t respond to first and second line antiepileptic agents.
- SRSE refers to status epilepticus that continues for at least 24 hours after anesthetic agents have been given or which recurs once the drugs are stopped.
- The evidence to support current treatment options is not based on randomized clinical trials but instead relies on case series and expert opinions.
- The most common treatment for both disorders is continuous IV infusion of anesthetic drugs but the best dosing and the optimal administration rate remain controversial.
- Some clinicians have used non-drug approaches to RSE and SRSE but the evidence supporting these options is limited.
Vasquez A, Farias-Moeller R, Tatum W. Pediatric refractory and super refractory status epilepticus [Published online ahead of print May 19, 2018]. Seizure. DOI: https://doi.org/10.1016/j.seizure.2018.05.012.