title: Clinical outcomes following prolonged refractory status epilepticus (PRSE).
abstract: BACKGROUND
  To define the clinical profile and outcome of patients in prolonged refractory status epilepticus (PRSE), and investigate possible predictors of outcome.
  
  
  METHODS
  We reviewed 63 consecutive patients with PRSE cared for in the medical and neurointensive care units of three academic medical centers over a 9-year period. For this multi-center retrospective cohort study, PRSE was defined as SE that persisted despite at least 1 week of induced coma. Variables examined for their relationship to outcome included etiology, EEG, neuroimaging, and age.
  
  
  RESULTS
  Forty-two (66%) of 63 patients in PRSE survived to discharge from hospitalization. Fourteen (22%) patients had a good outcome (mRS ≤ 3) at last available follow up (at least 6 months post-PRSE). Of these, 6 (10%) individuals had no significant disability and were able to carry out all usual activities (mRS = 1). Normal neuroimaging and a reactive EEG at onset of PRSE were associated with good outcome. Good or excellent clinical outcomes were possible in patients in PRSE for up to 79 days, and in patients up to 69 years old.
  
  
  CONCLUSIONS
  Good outcome is not unusual in PRSE, including in some older patients, in a variety of diagnoses, and despite months of coma.
authors.affiliation: Division of Epilepsy, Massachusetts General Hospital, Boston, MA 02114, USA. rkilbride@partners.org
authors.forename: R D
authors.initials: RD
authors.lastname: Kilbride
authors.forename: A S
authors.initials: AS
authors.lastname: Reynolds
authors.forename: J P
authors.initials: JP
authors.lastname: Szaflarski
authors.forename: L J
authors.initials: LJ
authors.lastname: Hirsch
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018681:Anesthetics, General / Q000627:therapeutic use*; D015331:Cohort Studies; D004569:Electroencephalography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D013226:Status Epilepticus / Q000188:drug therapy* / Q000401:mortality / Q000503:physiopathology; D017211:Treatment Failure; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D018681:Anesthetics, General