Neurosteroids and Status Epilepticus

Status epilepticus (SE) is a common neurological emergency with considerable associated health-care costs, morbidity, and mortality. In about one-third of cases, SE is refractory towards first-line intravenous benzodiazepines. Allopregnanolone, a neurosteroid that positively modulates synaptic and extrasynaptic γ-aminobutyric acid type A receptors, has been evaluated as a possible novel treatment for SE. Notwithstanding the positive results obtained in the animal models of SE, the use of allopregnanolone for the treatment of benzodiazepine-resistant SE in humans resulted in controversial findings. Here, we summarize the main preclinical and clinical evidence about the effects of neurosteroids on SE to provide a possible pathophysiological background for their rational use.