Introduction: Refractory status epilepticus (RSE) has been infrequently studied in Indian children. This study was conducted to study the clinico-etiological profile of children aged 1 month to 12 years with Convulsive RSE, and their short-term outcome.

Methods: This study was done in between 1^st April, 2016 and 28^th February, 2017 after IEC clearance. All children (aged 1 month to 12 years) who presented to the Pediatrics department of a tertiary-care public hospital with convulsive status epilepticus (CSE), or those who developed CSE during the hospital stay, were enrolled. All patients were investigated and managed as per a standard protocol. Outcome was assessed by Glasgow Outcome scale.  Details of those progressing to RSE were compared with those without RSE.

Results: 50 children (28 males) with CSE were enrolled, of which, 20 (40%) progressed to RSE. Central nervous infection was the commonest etiology (53% in SE and 55% in RSE, P>0.05), and non-compliance with anti-epileptic drugs was the next commonest etiology. Mortality rate was 38%; odds of death in RSE (50%) were higher than with SE (30%), but not statistically significant (P=0.15). The odds of having a poor outcome in children with RSE 6-times higher than in those having SE [OR (95%CI), 6 (1.6-22.3), P=0.005].

Conclusions: While managing CNS infections, pediatricians need to be aware of the high possibility of development of RSE, and need to emergently manage the same in an intensive-care setting, so as to reduce the mortality and morbidity due to this severe neurological condition.