Related Experiment Video
Updated: May 13, 2026
08:43
Long-term Continuous EEG Monitoring in Small Rodent Models of Human Disease Using the Epoch Wireless Transmitter System
Published on: July 21, 2015
Clinical outcomes following prolonged refractory status epilepticus (PRSE)
R D Kilbride1, A S Reynolds, J P Szaflarski
1Division of Epilepsy, Massachusetts General Hospital, Boston, MA 02114, USA. rkilbride@partners.org
Neurocritical Care
|March 13, 2013
Summary
Prolonged refractory status epilepticus (PRSE) can have good outcomes, even in older patients and after extended coma. Normal neuroimaging and reactive EEG predict better results in these challenging cases.
Area of Science:
- Neurology
- Critical Care Medicine
- Epileptology
Background:
- Prolonged refractory status epilepticus (PRSE) presents a significant clinical challenge.
- Understanding the clinical profile and outcomes of PRSE is crucial for patient management.
- Identifying predictors of outcome in PRSE can guide treatment strategies.
Purpose of the Study:
- To define the clinical profile and outcomes of patients experiencing prolonged refractory status epilepticus (PRSE).
- To investigate potential predictors associated with favorable outcomes in PRSE patients.
Main Methods:
- A multi-center retrospective cohort study involving 63 patients with PRSE over 9 years.
- PRSE was defined as status epilepticus (SE) persisting after at least one week of induced coma.
- Etiology, EEG, neuroimaging, and age were analyzed as potential outcome predictors.
Main Results:
- 66% of PRSE patients survived hospitalization; 22% achieved a good outcome (mRS ≤ 3) at 6-month follow-up.
- Normal neuroimaging and a reactive EEG at PRSE onset were linked to good outcomes.
- Favorable outcomes were observed in patients with PRSE lasting up to 79 days and in those up to 69 years old.
Conclusions:
- Good clinical outcomes are achievable in prolonged refractory status epilepticus (PRSE), contrary to expectations.
- Even prolonged coma (months) and advanced age do not preclude positive outcomes in PRSE.
- The findings suggest that PRSE, while severe, is not uniformly associated with poor prognosis.
Related Concept Videos
01:24Epilepsy and Seizures: Overview
Epilepsy is a chronic neurological disease marked by recurrent, unpredictable seizures. These seizures are caused by abnormal electrical discharges in the brain, leading to behavior, sensation, or consciousness alterations. They can also cause transient impairment of awareness, interfering with daily activities.
Various factors can trigger epilepsy, including genetic factors, brain damage, metabolic causes, and unknown etiology. Diagnosis of epilepsy involves electroencephalography (EEG), which...
Various factors can trigger epilepsy, including genetic factors, brain damage, metabolic causes, and unknown etiology. Diagnosis of epilepsy involves electroencephalography (EEG), which...
01:20Seizures l: Introduction
Understanding seizures and epilepsy relies on key definitions that help in recognizing, classifying, and managing these disorders. These definitions provide a framework for recognizing, classifying, and managing seizure disorders.DefinitionsA seizure is a sudden, abnormal burst of electrical activity in the brain that can cause changes in awareness, movement, sensation, or behavior, depending on the area involved. Epilepsy is a chronic condition characterized by recurrent, unprovoked seizures,...
01:26Psychosis: Goals of Pharmacotherapy
Antipsychotic drugs are a crucial treatment method for acute and chronic psychoses, bipolar illness, and behavioral disorders. The selection of these drugs depends on several factors, including the state of the disease, clinical judgment, possible drug interactions, and the patient's sensitivity to adverse effects. In immediate scenarios, such as delirium and dementia, short-term treatment with low doses of high-potency typical or atypical agents can effectively manage symptom exacerbation. For...
01:20Antiepileptic Drugs: Potassium Channel Activators
Ezocgabine or retigabine, an antiepileptic drug of remarkable efficacy, has revolutionized the management of seizures. It is a potassium channel activator, explicitly targeting the family of Q subtype potassium channels. It enhances the transmembrane potassium currents, regulating neuronal excitability. This action stabilizes the resting membrane potential, a pivotal factor in mitigating the hyperexcitability that characterizes epilepsy.
Ezogabine has gained approval as an adjunctive treatment...
Ezogabine has gained approval as an adjunctive treatment...
01:30Electroconvulsive Therapy
Electroconvulsive therapy (ECT), or shock therapy, remains a critical biomedical intervention for severe, treatment-resistant depression. While its origins can be traced back to Hippocrates' observations that malaria-induced convulsions alleviated mental illness, modern ECT has evolved significantly from its earlier, more primitive applications. First introduced in 1938 by Ugo Cerletti and his colleagues, ECT involves inducing controlled seizures using electrical currents. In its early years,...
01:22Epilepsy ll: Types
Recurrent seizures, stemming from abnormal electrical activity in the brain, are the defining characteristic of epilepsy, a chronic neurological condition. Because seizure features vary greatly, epilepsy is classified using two systems: by seizure type and by epilepsy syndromes. These classifications enable clinicians to describe seizure patterns and select suitable treatment strategies.I. Classification by Seizure Type1. Focal EpilepsyFocal epilepsy begins in one hemisphere of the brain.