Refractory status epilepticus

Purpose of review: Although conventional anticonvulsant agents can terminate status epilepticus in most cases, a substantial minority of patients develops medically refractory status and requires more aggressive care. This review explores the options available. Recent findings: Increasing numbers of previously unexpected etiologies for refractory status epilepticus continue to be reported. There are also some promising new therapies on the horizon, both for the short and the longer terms. Summary: Refractory status epilepticus, while a challenge to the intensivist, can be treated with drugs that are commonly used by intensivists. The cooperation of an interested electroencephalographer is vital.