Treatment of Status Epilepticus with Anesthetic Drugs

Abstract

Refractory status epilepticus (RSE) is defined as status epilepticus (SE) that fails to respond to an appropriate dose of a first-line and a second-line antiepileptic drugs. At this point, treatment options include additional trials of nonsedating antiseizure medications and general anesthesia. Guidelines for the treatment of SE and RSE have been published by the European Federation of Neurological Societies (EFNS) [1] and the Neurocritical Care Society (NCS) [2]. Both have focused mostly on the treatment of generalized convulsive SE (GCSE), but they also offer some recommendations for the treatment of nonconvulsive SE (NCSE) (Table 28.1).