Ketamine for the Treatment of Refractory Status Epilepticus

Inclusion Criteria:

1. Adults 18 years of age or older
2. Patients with refractory status epilepticus unresponsive to appropriately dosed first line agents administered intravenous or intraosseous and one second line agent

   1. First line agents: lorazepam, midazolam, or diazepam
   2. Second line agents: phenytoin (20 mg/kg), valproate (40 mg/kg), levetiracetam (60 mg/kg), lacosamide (400 mg)
3. All etiologies of status epilepticus will be included

Exclusion Criteria:

1. Exclusively psychogenic non epileptic seizures
2. Pregnant individuals
3. Incarcerated individuals
4. Patients with hypersensitivity to ketamine or any component of the formulation
5. Conditions in which an increase in blood pressure would be hazardous
6. Focal motor status epilepticus
7. Status epilepticus lasting \> 24 hours prior to enrollment (SRSE)
8. Patients with EEG in the ictal-interictal continuum (IIC)