Status epilepticus (SE) is a serious disease, associated with a high morbid
ity and mortality, particularly if refractory to initial therapy. We descri
be the clinical manifestations and outcome in ten cases with refractory SE
admitted to our medical intensive care unit. Three of these selected group
of cases with SE had pre-existent epilepsia. Of the seven patients with new
-onset epilepsia, six had multiple underlying systemic diseases. The three
patients with pre-existent epilepsia had a favourable outcome of their SE.
However, in the seven patients without known structural and/or functional c
erebral defects SE was also refractory to second or third line therapy. Adm
inistration of thiopental suppressed epileptic activity only temporarily. N
one of them survived due to coexistent pathology and the onset of secondary
metabolic complications. Thus, especially cases with new-onset epilepsia d
ebuting as refractory SE in the presence of underlying systemic diseases ha
d a fatal outcome in our medical intensive care unit. (C) 1998 Elsevier Sci
ence B.V. All rights reserved.