Anesthestic agents and status epilepticus.

There is little evidence to guide the choice of intravenous anesthetic agent to treat refractory status epilepticus but midazolam, propofol, and barbiturates are widely used. It is impractical to use inhalational anesthetic agents in most circumstances and there is little experience with non-GABA-ergic agents such as ketamine. A more aggressive treatment approach, aiming for EEG suppression, is most likely to result in sustained cessation of seizure activity but this is associated with increased treatment-related complications. Side effects of treatment, including hypotension, gastric paresis, and pneumonia, are common and contribute independently to poor outcome and death.