Effects of ketamine in epilepsy

Abstract

Ketamine, a rapid-acting general anesthetic, was administered intravenously to 26 epileptics. The effects of ketamine on the patients' clinical seizures and electroencephalograms were compared with similar periods during alert and sleep states. Epileptic discharges were present in the alert electroencephalogram of 17 (65 percent) of the patients. Epileptic discharges were precipitated or aggravated by sleep in 15 patients (58 percent) and by ketamine in eight patients (31 percent). No siezures were recorded during ketamine anesthesia. Ketamine neither precipitates nor aggravates seizures and is less effective than natural sleep as an activator of epileptic discharges.

Consensus Guidelines on the Use of Intravenous Ketamine Infusions for Chronic Pain From the American Society of Regional Anesthesia and Pain Medicine, the American Academy of Pain Medicine, and the American Society of Anesthesiologists

“… 88 In humans, ketamine has been shown to enhance epileptic discharges, which may explain the rare occurrence of seizures. 89 , 90…”

Ketamine for the treatment of refractory status epilepticus

“…However, a similar study of human volunteers conducted by Corssen et al [11] rejected this conclusion. These authors found that ketamine did not cause epileptiform discharges in epilepsy patients or in normal subjects and that no evidence was available to support the notion that ketamine could induce or exacerbate convulsions, in contrast with the conclusions of Kayama [12,13].…”

Treatment of Status Epilepticus with Ketamine, Are we There yet?

“…Some experimental data [122,[229][230][231] and subsequent clinical observations [232] reached similar conclusions. However, the first clinical observations have not always been confirmed [233,234], and a wealth of experimental evidence favors an antiepileptic action ( Table 2). It is still considered to potentially be able to facilitate seizures at low doses, not at doses that will produce sedation or anesthesia [72].…”