Which anesthetic should be used in the treatment of refractory status epilepticus?

Anesthetic barbiturates in refractory status epilepticus.

Two patients with previous cerebral damage and seizures and three patients with acute inflammatory cerebral lesions developed status epilepticus. They were unresponsive to standard anticonvulsants, but anesthetic barbiturates (thiopental and pentobarbital) stopped the seizures promptly.

Which treatment option should be used?

The Efficacy of Propofol and Midazolam in Treatment of Refractory Status Epilepticus in Children

Background: In this study, we compared the efficacy and safety of propofol and midazolam in treatment of children’s refractory status epilepticus. Methods: We recruited 32 patients with refractory status epilepticus. Of those, 16 were treated primarily with midazolam and 16 received propofol. Results: We achieved complete seizure control in 6 (38%) patients treated by midazolam, and in 10 (63%)...

Comparison of Intravenous Anesthetic Agents for the Treatment of Refractory Status Epilepticus

Status epilepticus that cannot be controlled with first- and second-line agents is called refractory status epilepticus (RSE), a condition that is associated with significant morbidity and mortality. Most experts agree that treatment of RSE necessitates the use of continuous infusion intravenous anesthetic drugs such as midazolam, propofol, pentobarbital, thiopental, and ketamine, each of which...

Status epilepticus and refractory status epilepticus management.

Status epilepticus (SE) describes persistent or recurring seizures without a return to baseline mental status and is a common neurologic emergency. SE can occur in the context of epilepsy or may be symptomatic of a wide range of underlying etiologies. The clinician's aim is to rapidly institute care that simultaneously stabilizes the patient medically, identifies and manages any precipitant con...