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1 Supplementary Online Content Hocker SE, Britton JW, Mandrekar JN, Wijdicks EFM, Rabinstein AA. Predictors of outcome in refractory status epilepticus. Arch Neurol. Published online October 8, doi: /archneurol eappendix. Systemic complications etable. Patient age, etiology, treatment, and outcome of refractory status epilepticus This supplementary material has been provided by the authors to give readers additional information about their work.

2 eappendix. Systemic Complications Abstracted Patient characteristics abstracted included: (1) demographic data (age, gender, ethnicity); (2) history of seizures or SE; (3) type of SE (GCSE, NCSE partial or NCSE generalized); (4) etiology of SE; (5) cardiopulmonary data including heart rate and rhythm, development of myocardial infarction (MI), presence of hypotension, requirement for vasopressor support, presence of pulmonary edema and acid base status on presentation, development of pneumonia, presence of hypoxia, need for intubation and mechanical ventilation, duration of mechanical ventilatory support and requirement for tracheostomy; (6) occurrence of physical injury; (7) cerebrospinal fluid (CSF) content including glucose, protein and cell count; (8) serum glucose at presentation; (9) serum white blood cell (WBC) count at presentation; (10) AEDs and anesthetic agents administered; (11) dosages of AEDs; (12) duration of anesthetic use; (13) level of EEG suppression; and (14) duration of hospitalization. Definitions Hypotension was defined as a systolic blood pressure < 90 mmhg or mean arterial pressure (MAP) <50 mmhg. Bradycardia was defined as heart rate < 60 beats per minute (bpm) and tachycardia was defined as heart rate > 100 bpm. Hypoxia was defined as saturation of peripheral oxygen (SpO2) < 90%. MI was defined according to the definition proposed by the 2007 Joint ESC/ACCF/AHA/WHF Task Force for the Redefinition of Myocardial Infarction [1]. Presence of pneumonia was recorded if a diagnosis of pneumonia was documented in the clinical notes and the patient received a course of antibiotic therapy. Pulmonary edema was recorded if it was documented in the radiology report of any chest X-ray performed within 24 hours of hospital admission.. Reference 1. Thygesen K, Alpert JS, White HD, et al. Universal definition of myocardial infarction. Circulation. 2007;116(22):

3 etable. Patient Age, Cause, Treatment and Outcome of Refractory Status Epilepticus (RSE) Age, y Cause AEDs and Anesthetic Agents 93 Metabolic LZP,, LEV, 75 Intracranial, LEV, hemorrhage DZP 51 Metabolic,, LZP,, 52 Metabolic LZP,,, PHB, 54 Drug I/W LZP,, LEV 68 Trauma, LZP, PHB, 60 Systemic FEL, LEV,, PHB 55 Metabolic LEV, LZP, 65 Metabolic LZP,, PHB, 65 Brain tumor LZP,, VPA, LEV, 52 ECT DZP, LZP, 77 ECT LZP,,, LEV 91 Systemic LZP,, LEV, VPA 38 Systemic LZP,, VPA, 63 Intracranial LZP,, hemorrhage 62 Intracranial, LEV, hemorrhage MD 46 Low AED VPA, LZP, 45 Low AED LZP,, VPA, 46 Low AED LZP, VPA, 63 Trauma PHB, LEV, VPA, LZP 63 Systemic LZP, VPA, LEV,, PHB 8 Systemic LZP,,, Days in Anestheti c Coma Cardiopulmonar y Complications At Discharg e MRS At 3-6 mo 1 CA, P P P P P * 4 P P * * CA, P * * P P At 9-12 mo Brain tumor LZP,, * 6 6 6

4 57 Congenital / hereditary DZP, LZP,,, PHB,, VPA, FEL, 64 Drug I/W LZP,, VPA,, 58 AED change DZP, LEV, LZP,, PHB,, 20 Low AED, LZP,,, 23 Congenital / hereditary 33 Systemic 68 Intracranial hemorrhage LZP, VPA, LEV,, LZP, LEV, VPA, PHB,,,, LEV, VPA, PHB, 57 Brain tumor LZP,, 57 Brain tumor LZP,,, VPA, LEV 37 AED change LZP, VPA, LEV, 68 Metabolic LZP, PHB,, VPA, LEV 59 Cryptogenic LZP, DZP,, 75 CNS LZP,, VPA, PHB, 23 CNS, LEV,,, LEV,, VPA 74 Low AED LZP,, VPA,, 73 AVM, LZP, VPA, LEV, 18 Trauma DZP,, PHB, 48 IS LZP,,, VPA 18 Trauma LZP,,, 12 CA, P P P P CA, P 4 * * 3 CA P P * * 14 P CA, P CA, P CA P P 3 * * * P 6 6 6

5 37 CNS vasculitis,, 38 CNS LZP,, VPA, LEV,,,, KET, FEL 45 Autoimmune, LEV, PHB,, 66 Brain tumor LZP, LEV, VPA, PHB, 57 Low AED LZP,, VPA 37 Low AED VPA,, PHB, 47 IS, LZP, PHB, LZP 20 Autoimmune LZP,, LEV, PHB,, VPA, 18 CNS LZP,, LEV,, PHB,, VPA, LID, KET, ISO, FEL 28 CNS LZP,, 25 Cryptogenic LZP, DZP,, PHB, LEV,,,, ISO 52 CNS DZP,, LEV, 52 Low AED LEV, LZP,, VPA, 41 CNS LEV, VPA,, LAC 64 Metabolic LZP,,, 27 Brain tumor DZP, LEV,, 18 Congenital / LZP,, hereditary LEV,, 47 Cryptogenic LZP,,,, ISO, LAC, FEL, KET 12 P P CA, P P 4 3 * CA, P P 5 * * 60 P P P CA, P 5 * * * * 3 1 * 2 4 P * * 9 P 2 * * 90 CA, P 6 6 6

6 22 Autoimmune LEV,, 76 P 6 6 6, LZP,, LAC 48 Autoimmune LZP,, 17 CA, P 5 * *, PHB 72 IS LZP,, LEV, VPA,, 4 CA, P 5 * * Abbreviations: Drug I/W indicates drug intoxication/withdrawal; ECT, electroconvulsive therapy; low AED, low antiepileptic drug levels or missed doses; AED change, change in antiepileptic regimen; CNS, central nervous system; AVM, arteriovenous malformation; IS, ischemic stroke; LZP, lorazepam;, fosphenytoin; LEV, levetiracetam;, midazolam; DZP, diazepam;, propofol; PHB, phenobarbital; FEL, felbamate; VPA, valproic acid;, pentobarbital; KET, ketamine; LID, lidocaine; ISO, isoflurane; LAC, lacosamide; CA, cardiac arrhythmia requiring intervention; P, pneumonia; MRS, modified Rankin Scale. *Data available or unclear.