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Revista Ecuatoriana de Neurología

On-line version ISSN 2631-2581Print version ISSN 1019-8113


RIVERO-RODRIGUEZ, Dannys et al. Clinical And Outcome Analysis Of Patients With Refractory Status Epilepticus According To The Third-Line Treatment Scheme Used. Rev Ecuat Neurol [online]. 2023, vol.32, n.2, pp.61-66. ISSN 2631-2581.


The evidence available in the treatment of refractory status epilepticus (RSE) is limited.


Evaluate the clinical and outcome factors in patients with refractory status epilepticus (RSE) according the third line treatment used (midazolam-MDL and/or propofol-PRO).


Retrospective cohort study included 34 patients treated by RSE during November 2015 to June 2018.


Age, severity and etiology of RSE, pretreatment level of consciousness, anesthetic drugs (MDL-PRO), outcome at hospital discharge and 3 months according Rankin score.


Mean of age of the patients was 51.21±22.3 years and 32.4% (11) had previous history of epilepsy. Super RSE (SSRE) was diagnosed in 35.3% (12) of sample. Mortality reached up 50% of patients and extended to 55.9% at 3 months. Patients treated with MDL had higher rate of vasopressor needs (71.4% vs 50.0%) and the group who received a scheme of combined treatment MDL-PRO included mainly a SSRE patients (p≤0.01), higher rate of tracheostomy (p=0.03), vasopressor drugs (p=0.01) and diminished dosage of anesthetic drugs (p=0.05). Surveillance analysis according Kaplan Meier curve did not found significant differences at 3 months in survival rate between groups. MDL vs PRO (Log Rank=0. 17), MDL vs MDL-PRO (Log Rank=0. 49) y PRO vs MDL-PRO (Log Rank=0. 48).


Patients with RSE had a high mortality, without evidence of increase of mortality in groups according anesthetic drugs used and schemed of treatment applied.

Keywords : Status epilepticus; Refractory status epilepticus; Midazolam; Propofol; Induced therapeutic coma..

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