title: Intravenous immunoglobulins 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 intravenous immunoglobulins (IVIG) 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-four original articles were identified. A total of 33 adult patients were described as receiving IVIG for RSE. Seizure reduction/control with IVIG occurred in 15 of the 33 patients (45.4%), with 1 (3.0%) and 14 (42.4%) displaying partial and complete responses respectively. No adverse events were recorded.
  
  
  CONCLUSIONS
  Oxford level 4, GRADE D evidence exists to suggest an unclear impact of IVIG therapy in adult RSE. Routine use of IVIG in adult RSE cannot be recommended at this time.
authors.affiliation: Clinician Investigator Program, University of Manitoba, Winnipeg, Canada; Section of Neurosurgery, University of Manitoba, Winnipeg, Canada. Electronic address: umzeiler@myumanitoba.ca.
authors.forename: F A
authors.initials: FA
authors.lastname: Zeiler
authors.affiliation: Undergraduate Medicine, University of Manitoba, Winnipeg, MB, R3A 1R9, Canada. Electronic address: matuszcm@myumanitoba.ca.
authors.forename: M
authors.initials: M
authors.lastname: Matuszczak
authors.affiliation: Section of Neurology, Montreal Neurological Institute, McGill, 3801 rue University, Montreal, QC, H3A 2B4, Canada. Electronic address: jteitelbaum@hotmail.com.
authors.forename: J
authors.initials: J
authors.lastname: Teitelbaum
authors.affiliation: Section of Neurosurgery, University of Manitoba, Winnipeg, Canada. Electronic address: ckazina@exchange.hsc.mb.ca.
authors.forename: C J
authors.initials: CJ
authors.lastname: Kazina
authors.affiliation: 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.forename: L M
authors.initials: LM
authors.lastname: Gillman
mesh_terms: D000328:Adult; D016208:Databases, Factual / Q000706:statistics & numerical data; D000069279:Drug Resistant Epilepsy / Q000628:therapy*; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use*; D007155:Immunologic Factors / Q000627:therapeutic use*; D013226:Status Epilepticus / Q000628:therapy*
chemical_list: D016756:Immunoglobulins, Intravenous; D007155:Immunologic Factors
keywords: Adult; IVIG; Immunoglobulin; Intravenous immunoglobulins; Refractory status epilepticus; Status epilepticus