Hu Yuming, Peng Xiaoyan, Wang Xuefeng
Department of Neurology, The First Affiliated Hospital, Chongqing Medical University, Neurology Key Laboratory of Chongqing Education Commission of China, Chongqing, China.
Expert Rev Neurother. 2025 Aug;25(8):929-937. doi: 10.1080/14737175.2025.2524103. Epub 2025 Jun 29.
The prevention and treatment of super-refractory status epilepticus (SRSE) remains difficult. Rapid seizure termination and effective management of fatal complications are the keys to improving prognosis.
This review is based on the current literature related to SRSE published in the PubMed database from 2000-March 2025 using the keywords 'SRSE' and 'drug treatment.' The purpose of this article is to shed new light and perspective on the treatment of SRSE.
SRSE treatment should first target the primary disease that causes SRSE. As the primary disease improves, the frequency of attacks gradually decreases. However, persistent epileptic seizures can cause brain damage and functional disorders, thereby altering the evolution of the primary disease. Therefore, the quick termination of epileptic seizures in patients and the proper management of fatal complications are important measures that can improve patient prognosis. Ketamine, a KD and combination therapy are the most common treatments. Although no consensus has been established, these treatments are generally successful. Neuromodulation, new antiepileptic drugs and surgery are also promising therapeutic areas. However, most reports include individual cases or case series, and thus these drugs and methods should be used with caution.
超难治性癫痫持续状态（SRSE）的防治仍然困难重重。迅速终止癫痫发作以及有效处理致命并发症是改善预后的关键。
本综述基于2000年至2025年3月期间在PubMed数据库中发表的与SRSE相关的现有文献，使用关键词“SRSE”和“药物治疗”。本文旨在为SRSE的治疗提供新的见解和观点。
SRSE治疗应首先针对引发SRSE的原发性疾病。随着原发性疾病的改善，发作频率会逐渐降低。然而，持续性癫痫发作会导致脑损伤和功能障碍，从而改变原发性疾病的发展进程。因此，迅速终止患者的癫痫发作以及妥善处理致命并发症是能够改善患者预后的重要措施。氯胺酮、酮饮食（KD）及联合治疗是最常见的治疗方法。尽管尚未达成共识，但这些治疗总体上较为成功。神经调节、新型抗癫痫药物及手术也是有前景的治疗领域。然而，大多数报告仅包含个别病例或病例系列，因此这些药物和方法应谨慎使用。
