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VOLUME 20 , ISSUE 10 ( 2016 ) > List of Articles


Seizures - just the tip of the iceberg: Critical care management of super-refractory status epilepticus

Karen Lionel

Keywords : Critical care management, status epilepticus, super refractory

Citation Information : Lionel K. Seizures - just the tip of the iceberg: Critical care management of super-refractory status epilepticus. Indian J Crit Care Med 2016; 20 (10):587-592.

DOI: 10.4103/0972-5229.192047

License: CC BY-ND 3.0

Published Online: 01-09-2017

Copyright Statement:  Copyright © 2016; The Author(s).


Super-refractory status epilepticus (SRSE) is defined as status epilepticus (SE) that continues or recurs 24 h or more after the onset of anesthetic therapy, including those cases where SE recurs on the reduction or withdrawal of anesthesia. Although SRSE is a rare clinical problem, it is associated with high mortality and morbidity rates. This article reviews the treatment approaches and the systemic complications commonly encountered in patients with SRSE. As evident in our search of literature, therapy for SRSE and its complications have been based on clinical reports and expert opinions since there is a lack of controlled and randomized trials. Even though this complex condition starts as a neurological disorder, because of the associated systemic complications, it can be considered as a multisystem disorder requiring scrupulous attention and deliberate efforts to prevent, detect, and treat these systemic effects. We have critically reviewed the intensive care management for SRSE per se as well as its associated systemic complications. We believe that a good recovery can occur even after prolonged and severe SRSE as long as the systemic complications are detected early and managed appropriately.

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