Status epilepticus in children, both refractory and super-refractory

Author(s): Sofia Jones

Purpose Focusing on the epidemiology, etiologies, therapeutic approaches, and clinical outcomes of pediatric Refractory Status Epilepticus (RSE) and Super-Refractory Status Epilepticus (SRSE). Methods: Utilizing the MEDLINE database, narrative review of the medical literature. Results Status Epilepticus (SE) that does not respond appropriately to first- and second-line antiepileptic medications is referred to as RSE. When SE persists for at least 24 hours following anesthesia administration or recurs after its withdrawal, this condition is known as SRSE. Complex neurological emergencies like RSE and SRSE are associated with high mortality, long-term neurological dysfunction, and the lack of prompt identification of the underlying etiology presents management challenges, and prolonged seizures limit therapeutic options. The majority of treatment decisions are based on case series or the opinions of experts. Large prospective series or randomized clinical trials have not evaluated the comparative efficacy of various treatment approaches. The most common treatment for RSE and SRSE is continuous infusion of anesthetics, but many questions about the best dose and rate of administration remain unanswered. The utilization of nonpharmacological treatments is recorded in the event that series or reports with low level of proof. Children with RSE/SRSE frequently experience systemic complications as a result of poly pharmacy and a prolonged hospital stay, in addition to neurological complications brought on by prolonged seizures. Conclusion Neurological emergencies like RSE and SRSE have few treatment options. Evaluations of the current RSE/SRSE therapies' safety and efficacy, as well as their potential impact on patient outcomes, would benefit from international collaboration