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Recent studies in adults suggest that anesthetic agents such as propofol and thiopental are therapeutic in status epilepticus refractory to conventional IV anticonvulsants.1,2 Studies in children with this syndrome are largely retrospective and suggest that, while most episodes of status epilepticus respond to benzodiazepines, phenytoin or fosphenytoin, barbiturates, or IV anesthetics like midazolam,3–5 other, newer anticonvulsants like topiramate may be useful even in those who have failed conventional treatment.6 In this issue of Neurology, van Gestel et al.7 present a retrospective examination of drug safety and efficacy in children with refractory status epilepticus (34 episodes in 33 children) who received propofol or thiopental between January 1993 and January 2004. Thiopental was the initial treatment for children who presented in status before 1999. Those who presented in 1999 or later were initially treated with propofol and subsequently …
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