title: Super-Refractory Status Epilepticus.
abstract: Although the vast majority of patients with status epilepticus (SE) respond fairly well to the first- or second-line anti-epileptics, a minority require anesthetic agents to put the seizures under control. An even smaller number of patients do not even respond to those and constitute the subgroup of super-refractory SE. Because of the small numbers, there are no definitive studies regarding its etiology, pathophysiology, and treatment, and those are still based on expert opinions. Encephalitides, either infectious, autoimmune, or paraneoplastic may be the main etiological factors. Induced pharmacological coma, immunosuppression, electrical brain stimulation, hypothermia, and ketamine are few of the newer but unproven therapeutic approaches that should be considered.
authors.affiliation: Neurocritical Care Services, Department of Neurology, Henry Ford Hospital, K-11, 2799 West Grand Blvd, Detroit, MI, 48202, USA. mruiz1@hfhs.org.
authors.forename: Mauricio Ruiz
authors.initials: MR
authors.lastname: Cuero
authors.affiliation: Neurocritical Care Services, Department of Neurology, Henry Ford Hospital, K-11, 2799 West Grand Blvd, Detroit, MI, 48202, USA. pvarela1@hfhs.org.|Wayne State University, Detroit, MI, USA. pvarela1@hfhs.org.
authors.forename: Panayiotis N
authors.initials: PN
authors.lastname: Varelas
mesh_terms: D000818:Animals; D000927:Anticonvulsants / Q000627:therapeutic use*; D015551:Autoimmunity; D006801:Humans; D012640:Seizures / Q000209:etiology; D013226:Status Epilepticus / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology; D016896:Treatment Outcome
chemical_list: D000927:Anticonvulsants
keywords: Autoimmune; Barbiturates; Encephalitis; Ketamine; Status epilepticus; Super refractory