Transcranial focal current stimulation in super-refractory status epilepticus in a pregnant patient

Super-refractory status epilepticus (SRSE) during pregnancy is a rare, life-threatening condition with limited therapeutic options. Transcranial focal current stimulation (TFS) has shown benefit in refractory epilepsy, but its use in SRSE during pregnancy has not been reported. We describe a woman in her 20s at 12 weeks' gestation with longstanding focal drug-resistant epilepsy who developed SRSE despite escalation of antiseizure medications and multiple intravenous anaesthetic regimens, requiring prolonged intensive care and mechanical ventilation. Neuroimaging revealed frontal gliotic lesions, and continuous electroencephalographic monitoring demonstrated persistent ictal activity, guiding subsequent therapeutic interventions. After multidisciplinary discussion and informed consent, TFS was administered over two consecutive days. No maternal or fetal adverse effects were observed, seizure activity resolved and sedation was successfully withdrawn with neurological recovery. The pregnancy progressed without complications and a healthy neonate was delivered at 38 weeks. TFS was temporally associated with resolution of SRSE without maternal or fetal adverse effects.