<![CDATA[Background : Refractory Status Epilepticus (RSE) is a condition of persistent status epilepticus seizures despite appropriate anticonvulsant therapy. RSE can be fatal if not treated promptly and properly. Standard treatments for SE and RSE include benzodiazepines as first line, non-benzodiazepine agents as second line, and general anesthetic agents as third line. Magnesium Sulfate (MgSO4) is known as an anticonvulsant agent that is more often used in obstetric cases, but its use in non- obstetric RSE is limited. The purpose of this case report is to report a case of RSE that improved after administration of Mgs4Case Illustration : A 56-year-old male patient with a history of epilepsy and left ischemic stroke, was referred with decreased consciousness after falling. The patient experienced recurrent seizures, and after treatment with diazepam and phenytoin, recurrent seizures were still found despite additional doses. After being transferred to the ICU, the patient was given therapy with midazolam, propofol, and phenobarbital, but the seizures continued to recur. After 30 hours in the ICU, MgSO4 was given intravenously two grams followed by maintenance doses. The seizures stopped and the patient remained seizure- free during the 138-hour ICU stay, with improved neurological and hemodynamic conditions.Conclusion : Â MgSO4 has been shown to be effective as an anticonvulsant agent in RSE in the ICU. Its use helps stop persistent seizures and supports the patient's clinical stability. This report shows the potential of MgSO4 as a useful adjunct therapy in the management of RSE in critically ill patients.]]>
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