[S1] Symposium　1: Status Epilepticus

[S1-1A-1] Therapeutic Burst-Suppression Coma in Pediatric Refractory Status Epilepticus

^○Jainn-Jim Lin^{1, 2, 3, 4} (1.Division of Pediatric Critical Care and Pediatric Neurocritical Care Center, Chang Gung Children’s Hospital and Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taoyuan, Taiwan, 2.Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan, 3.Division of Pediatric Neurology, Chang Gung Children’s Hospital and Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taoyuan, Taiwan, 4.Chang Gung Children’s Hospital Study Group for Children with Encephalitis/Encephalopathy Related Status Epilepticus and Epilepsy (CHEESE), Taoyuan, Taiwan)

Refractory status epilepticus is a neurological emergency with high rates of mortality and morbidity. It is defined as patients who continue to experience seizures after optimal treatment, including adequate doses of an initial benzodiazepine followed by a second intravenous antiepileptic drug [1,2]. The prevalence of refractory status epilepticus in children depends on the etiology, with reported mortality and morbidity rates of up to 32% and 36%, respectively. The primary goal of treatment for refractory status epilepticus is to stop the seizures in order to avoid further cerebral damage and other morbidities. The continuous infusion of antiepileptic drugs is usually recommended for such patients, however recent guidelines have recommended that the primary goal of treatment should be either the suppression of electrographic seizure activity or therapeutic burst-suppression coma, typically for 12 to 24 hours. However, evidence of the beneficial effects of therapeutic burst-suppression coma on clinical outcomes in children with refractory status epilepticus is limited and the clinical outcomes of this treatment strategy are largely unknown. Therefore, we review the current literature of the outcomes of therapeutic burst-suppression coma in children with refractory status epilepticus.