title: Therapeutic Hypothermia for Refractory Status Epilepticus.
abstract: BACKGROUND
  Our goal was to perform a systematic review of the literature on the use of therapeutic hypothermia for refractory status epilepticus (RSE) and its 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 May 2014), reference lists of relevant articles, and gray literature were searched. The strength of evidence was adjudicated by two independent reviewers, using both the Oxford and GRADE methodology.
  
  
  RESULTS
  Overall, 13 studies were identified, with 10 manuscripts and 3 meeting abstracts. A total of 40 patients were treated. The common target temperature was 33 degrees Celsius, sustained for a median 48 hours. Patients displayed a 62.5%, 15% and 22.5% rate of seizure cessation, seizure reduction, and failure of treatment respectively. External cooling was utilized in the majority of cases. Deep venous thrombosis, coagulopathy and infections were the commonly reported complications. Two ongoing clinical trials were identified.
  
  
  CONCLUSIONS
  Oxford level 4, GRADE D evidence exists to support the use of therapeutic hypothermia to control seizures in RSE. Further prospective study is warranted.
authors.affiliation: 1Section of Neurosurgery,McGill,Montreal,Canada.
authors.forename: Frederick A
authors.initials: FA
authors.lastname: Zeiler
authors.affiliation: 3Section of Critical Care Medicine,Department of Medicine,University of Manitoba,Winnipeg;Section of Neurocritical Care,McGill,Montreal,Canada.
authors.forename: Kaitlin J
authors.initials: KJ
authors.lastname: Zeiler
authors.affiliation: 3Section of Critical Care Medicine,Department of Medicine,University of Manitoba,Winnipeg;Section of Neurocritical Care,McGill,Montreal,Canada.
authors.forename: Jeanne
authors.initials: J
authors.lastname: Teitelbaum
authors.affiliation: 2Section of General Surgery,Department of Surgery,McGill,Montreal,Canada.
authors.forename: Lawrence M
authors.initials: LM
authors.lastname: Gillman
authors.affiliation: 1Section of Neurosurgery,McGill,Montreal,Canada.
authors.forename: Michael
authors.initials: M
authors.lastname: West
mesh_terms: D002986:Clinical Trials as Topic; D000069279:Drug Resistant Epilepsy / Q000628:therapy*; D019317:Evidence-Based Medicine; D006801:Humans; D007036:Hypothermia, Induced / Q000009:adverse effects / Q000379:methods; D012640:Seizures / Q000628:therapy; D013226:Status Epilepticus / Q000628:therapy*; D016896:Treatment Outcome
keywords: Critical Care; Epilepsy; Epilepsy - Expermental; Hypothermia; Intensive Care; Neurocritical Care