title: Plasmapheresis for refractory status epilepticus, part I: A scoping systematic review of the adult literature.
abstract: OBJECTIVE
  Our goal was to perform a scoping systematic review of the literature on the use of plasmapheresis or plasma exchange (PE) for refractory status epilepticus (RSE) in adults.
  
  
  METHODS
  Articles from MEDLINE, BIOSIS, EMBASE, Global Health, Healthstar, Scopus, Cochrane Library, the International Clinical Trials Registry Platform, clinicaltrials.gov (inception to May 2016), reference lists of relevant articles, and gray literature were searched. The strength of evidence was adjudicated using both the Oxford and GRADE methodology by two independent reviewers.
  
  
  RESULTS
  Twenty-two original articles were identified. Twenty-seven adult patients were described in these articles, with a variety of autoimmune conditions leading to RSE. Seizure response with the application of PE therapy occurred in 14 of the 27 patients (51.9%), with 1 (3.7%) and 13 (48.1%) displaying partial and complete responses respectively. Generalized RSE was the most likely seizure subtype to respond to PE therapy. One patient had recorded an adverse events related to PE therapy.
  
  
  CONCLUSIONS
  Oxford level 4, GRADE D evidence exists to suggest an uncertain response of adult autoimmune RSE to PE therapy. Thus, the routine application of PE therapy for adult autoimmune RSE cannot be recommended at this time.
authors: Clinician Investigator Program, University of Manitoba, Winnipeg, Canada; Section of Neurosurgery, University of Manitoba, Winnipeg, Canada. Electronic address: umzeiler@myumanitoba.ca.
authors: F A
authors: FA
authors: Zeiler
authors: Section of Neurosurgery, University of Manitoba, Winnipeg, Canada. Electronic address: matuszcm@myumanitoba.ca.
authors: M
authors: M
authors: Matuszczak
authors: Undergraduate Medicine, University of Manitoba, Winnipeg, Canada. Electronic address: jteitelbaum@hotmail.com.
authors: J
authors: J
authors: Teitelbaum
authors: Section of Neurosurgery, University of Manitoba, Winnipeg, Canada. Electronic address: ckazina@exchange.hsc.mb.ca.
authors: C J
authors: CJ
authors: Kazina
authors: Section of Neurology, Montreal Neurological Institute, McGill, Montreal, Canada; Section of Critical Care Medicine, Dept. of Medicine, University of Manitoba, Winnipeg, Canada; Section of General Surgery, Dept. of Surgery, University of Manitoba, Winnipeg, Canada. Electronic address: gillmanlm@gmail.com.
authors: L M
authors: LM
authors: Gillman
mesh_terms: D016208:Databases, Factual / Q000706:statistics & numerical data; D006801:Humans; D010956:Plasmapheresis / Q000379:methods*; D013226:Status Epilepticus / Q000628:therapy*
keywords: Adults; PLEX; Plasma exchange; Plasmapheresis; Refractory seizures; Status epilepticus