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VOLUME 19 , ISSUE 5 ( 2015 ) > List of Articles

CASE REPORT

Intravenous ketamine for treatment of super-refractory convulsive status epilepticus with septic shock: A report of two cases

Gentle Sunder Shrestha, Pankaj Joshi, Santosh Chhetri, Ragesh Karn, Subhash Acharya

Keywords : Ketamine, septic shock, super-refractory status epilepticus

Citation Information : Shrestha GS, Joshi P, Chhetri S, Karn R, Acharya S. Intravenous ketamine for treatment of super-refractory convulsive status epilepticus with septic shock: A report of two cases. Indian J Crit Care Med 2015; 19 (5):283-285.

DOI: 10.4103/0972-5229.156484

License: CC BY-ND 3.0

Published Online: 01-04-2016

Copyright Statement:  Copyright © 2015; The Author(s).


Abstract

Refractory and super-refractory status epilepticus is a life-threatening neurological emergency, associated with high morbidity and mortality. Treatment should be aimed to stop seizure and to avoid cerebral damage and another morbidity. Published data about effectiveness, safety and outcome of various therapies and treatment approaches are sparse and are mainly based on small case series and retrospective data. Here we report successful management of two cases of super-refractory status epilepticus refractory to anesthetic therapy with midazolam and complicated by septic shock, managed successfully with ketamine infusion.


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  1. Brophy GM, Bell R, Claassen J, Alldredge B, Bleck TP, Glauser T, et al. Guidelines for the evaluation and management of status epilepticus. Neurocrit Care 2012;17:3-23.
  2. Shorvon S, Ferlisi M. The treatment of super-refractory status epilepticus: A critical review of available therapies and a clinical treatment protocol. Brain 2011;134:2802-18.
  3. Novy J, Rossetti AO. Oral pregabalin as an add-on treatment for status epilepticus. Epilepsia 2010;51:2207-10.
  4. Ferlisi M, Shorvon S. The outcome of therapies in refractory and super-refractory convulsive status epilepticus and recommendations for therapy. Brain 2012;135:2314-28.
  5. Hijazi Y, Bodonian C, Bolon M, Salord F, Boulieu R. Pharmacokinetics and haemodynamics of ketamine in intensive care patients with brain or spinal cord injury. Br J Anaesth 2003;90:155-60.
  6. Morris C, Perris A, Klein J, Mahoney P. Anaesthesia in haemodynamically compromised emergency patients: Does ketamine represent the best choice of induction agent? Anaesthesia 2009;64:532-9.
  7. Gaspard N, Foreman B, Judd LM, Brenton JN, Nathan BR, McCoy BM, et al. Intravenous ketamine for the treatment of refractory status epilepticus: A retrospective multicenter study. Epilepsia 2013;54:1498-503.
  8. Synowiec AS, Singh DS, Yenugadhati V, Valeriano JP, Schramke CJ, Kelly KM. Ketamine use in the treatment of refractory status epilepticus. Epilepsy Res 2013;105:183-8.
  9. Holtkamp M, Othman J, Buchheim K, Masuhr F, Schielke E, Meierkord H. A "malignant" variant of status epilepticus. Arch Neurol 2005;62:1428-31.
  10. Krishnamurthy KB, Drislane FW. Relapse and survival after barbiturate anesthetic treatment of refractory status epilepticus. Epilepsia 1996;37:863-7.
  11. Naylor DE, Liu H, Wasterlain CG. Trafficking of GABA(A) receptors, loss of inhibition, and a mechanism for pharmacoresistance in status epilepticus. J Neurosci 2005;25:7724-33.
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