Ten patients with refractory status epilepticus in an intensive care department

Status epilepticus (SE) is a serious disease, associated with a high morbidity and mortality, particularly if refractory to initial therapy. We describe the clinical manifestations and outcome in ten cases with refractory SE admitted to our medical intensive care unit. Three of these selected group of cases with SE had pre-existent epilepsia. Of the seven patients with new-onset epilepsia, six had multiple underlying systemic diseases. The three patients with pre-existent epilepsia had a favourable outcome of their SE. However, in the seven patients without known structural and/or functional cerebral defects SE was also refractory to second or third line therapy. Administration of thiopental suppressed epileptic activity only temporarily. None of them survived due to coexistent pathology and the onset of secondary metabolic complications. Thus, especially cases with new-onset epilepsia debuting as refractory SE in the presence of underlying systemic diseases had a fatal outcome in our medical intensive care unit. (C) 1998 Elsevier Science B.V. All rights reserved.