New-onset refractory status epilepticus treatment [Neurosurgery Wiki]

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====== New-onset refractory status epilepticus treatment ======

see [[Status epilepticus treatment]].

The treatment [[protocol]] is intensive and includes [[benzodiazepine]]s, [[anticonvulsant]]s, and eventually [[anesthetic]]s for [[induced coma]] when polypharmacy is exhausted
((D. A. Greenberg, M. J. Aminof, and R. P. Simon, Clinical
Neurology, McGraw-Hill Education, New York, NY, USA, 9th
edition, 2015.)).

Seizures in [[NORSE]] do not respond to the standard status epilepticus medications; hence the majority of patients are treated with an anesthesia-induced coma and monitored in [[ICU]]s 
((Wilder-Smith EP, Lim EC, Teoh HL, Sharma VK, Tan JJ, Chan BP, Ong BK. The
NORSE (new-onset refractory status epilepticus) syndrome: defining a disease
entity. Ann Acad Med Singapore. 2005 Aug;34(7):417-20. PubMed PMID: 16123813.
)).

If seizures continue or recur after 24 hours following treatment with anesthetics, it is termed [[super refractory status epilepticus]] (SRSE). Because of high [[mortality]] with polypharmacy and continuous [[anesthetic]] use, there has been a great interest to use nonmedicinal devices like VNS.

===== Vagus nerve stimulation =====

[[Vagus nerve stimulation for New-onset refractory status epilepticus]].