Varying underlying causes make super-refractory status epilepticus (SRSE) management more difficult1

Status epilepticus (SE) that evolves into super-refractory status epilepticus (SRSE) can have a variety of causes, or may appear without identifiable cause.2-5

Potential Causes of SRSE

structural causes
  • Cerebrovascular2,4,5
  • Metabolic2,4,5
  • Tumors2,4,5
  • Medication induced/overdose2,4,5
  • Immunological disorders2,3
  • Mitochondrial disorders3,5
non structural causes
  • Anoxia6
  • Hypoxia6
  • Low antiepileptic drug levels6
  • Alcohol6
  • Trauma6
  • CNS infections6
  • Infectious diseases3,5
  • Drugs/toxins5
  • Genetic disorders3,5
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Complications of Managing a SRSE Patient

Learn about the complex SRSE patient from Stephan Mayer, MD, FCCM


  1. Shorvon S, Ferlisi M. The treatment of super-refractory status epilepticus: a critical review of available therapies and a clinical treatment protocol. Brain. 2011;134(10):2802-2818.
  2. Kinney M, Craig J. Grand rounds: an update on convulsive status epilepticus. Ulster Med J. 2015;84(2):88-93.
  3. Trinka E, Hofler J, Zerbs A. Causes of status epilepticus. Epilepsy. 2012;53(4):127-138.
  4. Neligan A, Shorvon SD. Frequency and prognosis of convulsive status epilepticus of different causes: a systematic review. Epilepsy Res. 2010;91(2-3):111-122.
  5. Tan RY, Neligan A, Shorvon SD. The uncommon causes of status epilepticus: a systematic review. Epilepsy Res. 2010;91(2-3):111-122.
  6. DeLorenzo RJ, Pellock JM, Towne AR, Boggs JG. Epidemiology of status epilepticus. J Clin Neurophysiol. 1995;12(4):316-325.