Hypothermia and barbiturate coma for refractory status epilepticus

Orlowski, James P.; Erenberg, Gerald; Lueders, Hans; Cruse, Robert P.

doi:10.1097/00003246-198404000-00006

Cited by 146 publications

(96 citation statements)

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“…21 One study demonstrated control of refractory status epilepticus in three children with a combination of hypothermia to 30°to 31°C combined with thiopental. 22 Detecting NCS and NCSE is important so that appropriate treatment can be initiated. Clinical studies are consistent with the hypothesis that continuous electrographic discharges, even without clinical seizures, can be harmful.…”

Section: Figure Background Evolution and Seizure Occurrence By Subjectmentioning

confidence: 99%

Electroencephalographic monitoring during hypothermia after pediatric cardiac arrest

Abend¹,

Topjian²,

Ichord³

et al. 2009

Neurology

194

162

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Section: Figure Background Evolution and Seizure Occurrence By Subjectmentioning

confidence: 99%

Electroencephalographic monitoring during hypothermia after pediatric cardiac arrest

Abend¹,

Topjian²,

Ichord³

et al. 2009

Neurology

194

162

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“…For these reasons, many different protocols are used in treating RSE (4). One of the most frequently used and the best studied protocol in the United States involves use of high-dose barbiturates (9)(10)(11)(12)(13)(14)(15)(16). High-dose barbiturate treatment is associated with significant mortality ranging from 10 to 75 depending on the study.…”

mentioning

confidence: 99%

Treatment of Refractory Status Epilepticus with Propofol: Clinical and Pharmacokinetic Findings

et al. 1998

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Summary: Purpose:We compared propofol with high-dose barbiturates in the treatment of refractory status epilepticus (RSE) and propose a protocol for the administration of propofol in RSE in adults, correlating propofol's effect with plasma levels.Methods: Sixteen patients with RSE were included; 8 were treated primarily with high-dose barbiturates and 8 were treated primarily with propofol.Results: Both groups of patients had multiple medical problems and a subsequent high mortality. A smaller but not statistically significant fraction of patients had their seizures controlled with propofol (63%) than with high-dose barbiturate therapy (82%). The time from initiation of high-dose barbiturate therapy to attainment of control of RSE was longer (123 min) than the time to attainment of seizure control in the group receiving propofol (2.6 min, p = 0.002). Plasma concentrations of propofol associated with control of SE were 14 pM +. 4 (2.5 p,g/ml). Recurrent seizures were common when propofol infusions were suddenly discontinued but not when the infusions were gradually tapered.Conclusions: If used appropriately, propofol infusions can effectively and quickly terminate many but not all episodes of RSE. Propofol is a promising agent for use in treating RSE, but more studies are required to determine its true value in comparison with other agents.

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“…Ketogenic diet is associated with acidosis, constipation, hypoglycemia, and hypercholesterolemia. The successful use of magnesium infusion and hypothermia in status epilepticus has also been reported [12,13].…”

Section: Case Reportmentioning

confidence: 89%

Febrile Infection-Related Epilepsy Syndrome: A Rare Case Presentation

Reghu

James²,

Reji³

et al. 2017

Asian J Pharm Clin Res

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Febrile infection-related epilepsy syndrome is characterized by super refractory status epilepticus that is resistant to conventional antiepileptic drugs. This case report critically analyses the treatment options adopted in a hospital to manage this syndrome. Despite the aggressive efforts that were taken, the patient succumbed to the complications of the illness and side effects of the treatment strategies adopted. This shows that the treatment options currently available are in adequate, so an intensive research in the area of pathogenesis of status epilepticus is required to frame treatment strategies that can bring out better outcomes.

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Hypothermia and barbiturate coma for refractory status epilepticus

Cited by 146 publications

References 0 publications

Electroencephalographic monitoring during hypothermia after pediatric cardiac arrest

Electroencephalographic monitoring during hypothermia after pediatric cardiac arrest

Treatment of Refractory Status Epilepticus with Propofol: Clinical and Pharmacokinetic Findings

Febrile Infection-Related Epilepsy Syndrome: A Rare Case Presentation

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