ReviewThe Lancet. Neurology2011
Management of refractory status epilepticus in adults: still more questions than answers.
Review in The Lancet. Neurology, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 124 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
124 citing papers in PubMed, 2 syntheses or guidelines pooled it, 339 citations in OpenAlex.
- Neuromodulation in new-onset refractory status epilepticus.Frontiers in neurology · 2023Pooled it
- Guidelines for the evaluation and management of status epilepticus.Neurocritical care · 2012Guideline
- Clinician-Reported Physical and Cognitive Impairments After Convulsive Status Epilepticus: Post Hoc Study of a Randomized Controlled Trial.Neurocritical care · 2024Trial
- Valproic acid as adjuvant treatment for convulsive status epilepticus: a randomised clinical trial.Critical care (London, England) · 2023Trial
- Expanding Indications for a Ketogenic Diet as an Adjuvant Therapy in Adult Refractory Status Epilepticus: an Exploratory Study Using Moderation Analysis.Neurotherapeutics : the journal of the American Society for Experimental NeuroTherapeutics · 2022Trial
- Intramuscular midazolam versus intravenous lorazepam for the prehospital treatment of status epilepticus in the pediatric population.Epilepsia · 2015Trial
- Trial
- Cyclic Recurrence of Seizures as a Marker for Super-Refractory Status Epilepticus.Brain and behavior · 2026Article
- Evaluating Treatment Dynamics in Refractory Status Epilepticus: A Retrospective Observational Cohort Study.The Neurohospitalist · 2026Article
- An extreme type of new onset refractory status epilepticus with stimulus-induced seizures in pharmacological isoelectric states.Epilepsia · 2026Article
- Review
- Fast Acute Sedation at Intensive Care vs. High-Dose IV Anti-seizure Medication for Treatment of Non-convulsive Status Epilepticus: A Randomized, Multicenter Trial.Critical care explorations · 2025Article
- Features, Outcome, and Treatment of Postanoxic Status Epilepticus: Pooled Analysis of 3 Cohorts.Neurology · 2025Article
- Total cerebral blood volume changes drive macroscopic cerebrospinal fluid flux in humans.PLoS biology · 2025Article
- Article
- Management of Status Epilepticus and Infections in a Patient with Lennox Gastaut Syndrome.The Canadian journal of hospital pharmacy · 2025Article
- Status epilepticus: the score question.Frontiers in neurology · 2025Review
- Article
- Perampanel as an Add-On Therapy in Patients with Refractory Status Epilepticus and Postanoxic Encephalopathy: A Real-Life Single-Center Retrospective Cohort Study.Neurocritical care · 2024Article
- Risperidone-Induced Hypothermia in a Cerebral Palsy Patient: A Case Report and Literature Review.Cureus · 2024Article
64 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
2 authors at 2 institutions in 2 countries.
Funding
Abstract
Refractory status epilepticus (RSE) is defined as status epilepticus that continues despite treatment with benzodiazepines and one antiepileptic drug. RSE should be treated promptly to prevent morbidity and mortality; however, scarce evidence is available to support the choice of specific treatments. Major independent outcome predictors are age (not modifiable) and cause (which should be actively targeted). Recent recommendations for adults suggest that the aggressiveness of treatment for RSE should be tailored to the clinical situation. To minimise intensive care unit-related complications, focal RSE without impairment of consciousness might initially be approached conservatively; conversely, early induction of pharmacological coma is advisable in generalised convulsive forms of the disorder. At this stage, midazolam, propofol, or barbiturates are the most commonly used drugs. Several other treatments, such as additional anaesthetics, other antiepileptic or immunomodulatory compounds, or non-pharmacological approaches (eg, electroconvulsive treatment or hypothermia), have been used in protracted RSE. Treatment lasting weeks or months can sometimes result in a good outcome, as in selected patients after encephalitis or autoimmune disorders. Well designed prospective studies of RSE are urgently needed.
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Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.