Neurology® Podcast Super Refractory Status Epilepticus Diagnosis, Management, and Prognostication
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Nov 10, 2025 Dr. Matthew Ryan Woodward, a Neurointensivist at the University of Maryland, dives deep into the complexities of status epilepticus. He discusses the critical transition to refractory and super-refractory states, shedding light on treatment implications. Matthew reveals insights from an international survey on real-world management variability, highlighting differences in diagnostics and prognostication. The conversation also touches on ableism in healthcare and strategies for better multidisciplinary collaboration in treatment practices.
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Trainee Experience Sparked the Study
- Matt Woodward describes his trainee experience noticing wide variability in SRSE care and limited guidance.
- He worked on a case series using electroconvulsive therapy as a salvage treatment and found little clear evidence to guide practice.
Survey Focus: Three Practical Domains
- Investigate SRSE across three domains: anti-seizure medications, diagnostic workup, and prognosis timing/content.
- Ask about IV anesthetics, nonpharmacologic adjuncts, underlying-cause evaluation, and when to prognosticate.
Wide Practice Variability In SRSE Care
- The survey revealed high variability in SRSE diagnosis, treatment, and prognostication across clinicians and centers.
- Availability of therapies strongly influences practice, and few clinicians transfer patients solely to access niche adjuncts like ECT.