Manuscript title: Super Refractory Status Epilepticus: The development of a paradigm for critical care management

Super Refractory status epilepticus (SRSE) is a sub category of status epilepticus recently defined as seizures that persist following 24 hours of critical care sedation. SRSE is associated with a high morbidity and mortality. Protocols for the management of SRSE have been proposed, but restricted clinical trial data compromises the ability to develop a comprehensive critical care treatment paradigm. The majority of the published literature relates to anecdotal reports, case series, reviews and opinion. The objective of this review is to consolidate the knowledge of the treatment of SRSE and develop a management paradigm providing a clear clinical guide to future clinical management and clinical trials.