title: Modern inhalational anesthetics for refractory status epilepticus.
abstract: BACKGROUND
  Our goal was to perform a systematic review of the literature on the use of modern inhalational anesthetic agents for refractory status epilepticus and their impact on seizure control.
  
  
  METHODS
  All articles from MEDLINE, BIOSIS, EMBASE, Global Health, HealthStar, Scopus, Cochrane Library, the International Clinical Trials Registry Platform (inception to March 2014), reference lists of relevant articles, and gray literature were searched. The strength of evidence was adjudicated using both the Oxford and Grading of Recommendation Assessment Development and Education methodology by two independent reviewers.
  
  
  RESULTS
  Overall, 19 studies were identified, with 16 manuscripts and 3 meeting abstracts. A total of 46 patients were treated. Adult (n=28) and pediatric patients (n=18) displayed 92.9% and 94.4% seizure control with treatment, respectively. Isoflurane was used in the majority of cases. Hypotension was the only complication described.
  
  
  CONCLUSIONS
  Oxford level 4, Grading of Recommendation Assessment Development and Education D evidence exists to support the use of isoflurane in refractory status epilepticus to obtain burst suppression. Insufficient data exist to comment on the efficacy of desflurane and xenon at this time.
authors.affiliation: 1Section of Neurosurgery,Department of Surgery,University of Manitoba,Winnipeg,Canada.
authors.forename: Frederick A
authors.initials: FA
authors.lastname: Zeiler
authors.affiliation: 2Section of Neurocritical Care,Montreal Neurological Institute,McGill,Montreal,Canada.
authors.forename: Kaitlin J
authors.initials: KJ
authors.lastname: Zeiler
authors.affiliation: 2Section of Neurocritical Care,Montreal Neurological Institute,McGill,Montreal,Canada.
authors.forename: Jeanne
authors.initials: J
authors.lastname: Teitelbaum
authors.affiliation: 4Section of Critical Care Medicine,Department of Medicine,University of Manitoba,Winnipeg,Canada.
authors.forename: Lawrence M
authors.initials: LM
authors.lastname: Gillman
authors.affiliation: 1Section of Neurosurgery,Department of Surgery,University of Manitoba,Winnipeg,Canada.
authors.forename: Michael
authors.initials: M
authors.lastname: West
mesh_terms: D000328:Adult; D018685:Anesthetics, Inhalation / Q000009:adverse effects / Q000627:therapeutic use*; D002648:Child; D000069279:Drug Resistant Epilepsy / Q000188:drug therapy; D019317:Evidence-Based Medicine; D017408:Guidelines as Topic; D006801:Humans; D013226:Status Epilepticus / Q000188:drug therapy*; D016896:Treatment Outcome
chemical_list: D018685:Anesthetics, Inhalation
keywords: status epilepticus