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The surgical treatment of status epilepticus

While the role of surgery in the management of refractory focal epilepsy is established, it is much less frequently used in the treatment of status epilepticus (SE). With the exception of hemispherectomy in the epilepsia partialis continua of Rasmussen’s encephalitis, current literature on the subject comprises a handful of small case series and anecdotal reports of disparate surgical procedures (Table 1), almost exclusively where SE is deemed refractory (RSE). In the situation of RSE caused by radiologically and/or electrophysiologically definable focal brain pathology, the role of surgical resection would appear an intuitive and logical one, although it does not often translate into clinical practice. Given its potential as a life-saving intervention, there is requirement for a better definition and understanding of the place of surgery in the modern management of SE.