Treatment of Status Epilepticus – a Narrative Review of the Evidence so Far and a Proposal for the Design of Retrospective Studies

Randomised controlled studies of the treatment of status epilepticus (SE) are difficult to perform due to ethical reasons. Therefore, the evidence for treatment guidelines is mainly based on observational studies, case series, case reports, and retrospective database analyses. The diversity of approaches used to determine the termination drug in a treatment episode of SE shows that the scientific community has not yet found a global means of defining when and if an antiepileptic drug is successful in terminating SE. More meta-analyses are needed in order to compare the treatment effects in the subtypes of non-convulsive SE because these are only small heterogeneous subdivisions in large database analyses. Furthermore, we propose that future case series, observational studies, or retrospective database analyses should follow certain standards to make them more comparable.