New-onset refractory status epilepticus treatment

see Status epilepticus treatment.

The treatment protocol is intensive and includes benzodiazepines, anticonvulsants, and eventually anesthetics for induced coma when polypharmacy is exhausted ¹⁾.

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 ICUs ²⁾.

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 for New-onset refractory status epilepticus.

¹⁾

D. A. Greenberg, M. J. Aminof, and R. P. Simon, Clinical Neurology, McGraw-Hill Education, New York, NY, USA, 9th edition, 2015.

²⁾

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.