propofol, midazolam, or thiopental/pentobarbital); Stage SRSE; after 24 hours in status. Treatments used and recommended for SRSE include the following in this order: anesthetic agents and antiepileptic drugs, identify and treat the cause, magnesium infusion, iv pyridoxine, consider steroids and immunotherapy, consider resective neurosurgery in lesional SE, consider multiple subpial transection, hypothermia, ketogenic diet, transcranial magnetic stimulation, vagal nerve stimulation, consider

more »

... p brain stimulation, electroconvulsive therapy, drainage of cerebrospinal fluid, and older drug therapies. Treatment of the underlying cause is stressed. Premature withdrawal of therapy is discouraged, since recovery can occur after even weeks of status epilepticus. A multinational database of outcomes of individual therapies is urgently needed. (Shorvon S, Ferlisi M. The treatment of super-refractory status epilepticus: a critical review of available therapies and a clinical treatment protocol. Brain 2011;134:2802-2818).