Efficacy of IV Ketamine in Refractory/Super-Refractory Status Epilepticus: A Systematic Review and Meta-Analysis

Abhijit Vijay, Lele and Alex, Raquer and Jorge, Mejia-Mantil and Samuel Tsan, Ern Hung and Gentle Sunder, Shrestha and Victor, Lin and Samuel Neal, Blacker and Sean, Marinelli and Peter Chee Seong, Tan and Sarah, Wahlster and Andres, Gempeler (2026) Efficacy of IV Ketamine in Refractory/Super-Refractory Status Epilepticus: A Systematic Review and Meta-Analysis. Neurology Clinical Practice, 16 (2). pp. 1-9. ISSN 2163-0933

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Abstract

Background and Objectives Intravenous ketamine is increasingly used for refractory and super-refractory status epilepticus(RSE/ SRSE), yet its efficacy and optimal use remain uncertain. We therefore aimed to synthesize the available evidence to quantify the effectiveness of ketamine in achieving seizure cessation and to explore differences in treatmentcharacteristics between patients who respond and those who do not. Methods We conducted a systematic review and meta-analysis to estimate the pooled seizure cessation rate associated with intravenous ketamine. Secondary analyses compared ketamine initiation timing, dosing, and infusion duration between patients who achieved seizure cessation (responders) and those who did not (nonresponders).

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