naa a22 4500 530185377 CHVBK 20181026074444.0 cr unu---uuuuu 181026e201810 xx s 000 0 eng 10.1111/epi.14481 doi (SERVAL)BIB_D0B3B1D71CEE 30159866 pmid 000446321100024 isiid Rossetti A.O. Place of neurosteroids in the treatment of status epilepticus [Elektronische Daten] [A.O. Rossetti] The treatment of refractory or super-refractory status epilepticus (SE) currently relies on low-evidence strategies, including general anesthetics to induce pharmacologic coma, ketogenic diet, immunosuppression, and other physical measures. Besides the formal uncertainty regarding efficacy, concerns have been about tolerability. In this situation, identification of alternative, higher evidence treatments is urgently needed. Allopregnanolone is an endogenous neurosteroid exerting a positive allosteric modulation on γ-aminobutyric acid (GABA) &lt;sub&gt;A&lt;/sub&gt; receptors. In animal experiments it has been demonstrated that this neurosteroid displays relevant antiseizure properties in a variety of SE models, and that the tolerance to benzodiazepines, relying on receptor internalization, does not affect its action. An experimental clinical use in patients with SE older than 2years was initated more than 5years ago. Being a naturally occurring compound, no relevant adverse events are expected, and until now its safety profile appears reassuring. Preliminary results of a phase I/II trial seemed promising, but a recent well-designed randomized, placebo-controlled trial could not find any difference in terms of efficacy; tolerability seemed nevertheless good. Patients with refractory and super-refractory SE still deserve further well-designed studies to improve current treatment options. Epilepsia 59 Suppl 2(2018-10), 216-219 59 Suppl 2<216-219 2018 59 Suppl 2 1 article serval SERVAL 100 1- Rossetti A.O. SERVAL 773 0- Epilepsia 59 Suppl 2(2018-10), 216-219 59 Suppl 2<216-219 2018 59 Suppl 2 BK010053 XK010053 XK010000 SERVAL SERVAL SERVAL article