title: Pediatric intensive care treatment of uncontrolled status epilepticus.
abstract: The critically ill mechanically ventilated child with ongoing seizures that are refractory to any treatment presents a distinct challenge in pediatric neurocritical care. The evidence base from randomized controlled trials on which anti-epileptic drug (AED) strategy should be used is inadequate. This review of refractory and super-refractory status epilepticus summarizes recent pediatric case series regarding definitions, the second-tier AED therapies once initial anticonvulsants have failed, and the experience of high-dose midazolam, barbiturate anesthesia, and volatile anesthetics for uncontrolled status epilepticus.
authors.affiliation: Division of Critical Care, Department of Anesthesia, Pain and Perioperative Medicine, Boston Children's Hospital, 300 Longwood Avenue, Boston, MA 02115, USA.
authors.forename: Ryan
authors.initials: R
authors.lastname: Wilkes
authors.forename: Robert C
authors.initials: RC
authors.lastname: Tasker
mesh_terms: D000759:Adjuvants, Anesthesia / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use; D000927:Anticonvulsants / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D001463:Barbiturates / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use; D002648:Child; D003422:Critical Care / Q000379:methods; D006801:Humans; D007022:Hypotension / Q000139:chemically induced; D015278:Intensive Care Units, Pediatric; D007442:Intubation, Intratracheal / Q000009:adverse effects / Q000379:methods / Q000592:standards*; D008874:Midazolam / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D012121:Respiration, Artificial / Q000009:adverse effects / Q000379:methods / Q000592:standards*; D013226:Status Epilepticus / Q000175:diagnosis / Q000188:drug therapy* / Q000628:therapy
chemical_list: D000759:Adjuvants, Anesthesia; D000927:Anticonvulsants; D001463:Barbiturates; D008874:Midazolam