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Refractory Status Epilepticus Treatment Health Articles | July 12, 2017

Refractory status epilepticus is a potentially life threatening medical emergency. It requires early diagnosis & tre



There is a lack of consensus upon it’s semantic definition of whether it is status epilepticus that continues despite TT with benzodiazepine. One epileptic medication is lorazepam plus phenytoin. Others regard refrectomy status epilepticus as a feature of benzodiazepine and antiepileptic medication i.e. lorazepam plus phenytoin plus phenobarb. All patient of refractory status epilepticus require continuous EEG monitoring. There are three main agents used in the treatment of Refractory Status Epilepticus (RSE). These include thiopental midazolam and propofol. RSE was shown to result in mortality in 35 % cases, 39.13 % of patients were left with severe neurological deficits while another 13% had mild neurological deficits.


A Case Study


A 3 year old boy with history of regression of milestones was referred to Shalby Indorewith a prodrome of headache Cheap Bryant Reeves Shirt , vomiting and swelling all over body for 5-6 days. He was admitted in other setup with status epilepticus, but seizures were not controlled at the time of admission and the child was in comatose state with refractomy multifocal and generalized seizure, which required admission to intensive care unit & administration of antiepilepticus and general Anaesthetics. The child was intubated Cheap Lorenzen Wright Shirt , was given ventilator support with IV midazolam and IV thiopental infusions were started along with blood investigations. The patient was intitally treated with acyclovir and antibacterial. A provisional diagnosis of inborn error of metabolism *mitochondirial encephalopathy) was made. Due to acute onset of infection mitochondrial cocktail therapy was started i.e. high dosage of Vitamins, Coq, Carnisure and Ketogenic diet. The patient was also given packed cell and FFP due to severe anemia and deranged coagulation profile.


Gradually the child started becoming neurologically and thermodynamically stable after 10 days of ventilator and lonotropes support were gradually withdrawn. IV anticonvulsant (thiopental & Midazolam Infusion) were tapered & shifted to IV gardenal Cheap Mike Bibby Shirt , IV fosdin, IV levipril & also tablet toperamade, which later changed to anticonvulsants. Clinically & EEG wise Cheap Shareef Abdur-Rahim Shirt , the convulsions were stopped completely and he is now being discharged with oral antiepilepticus and Mitochondrial cocktail therapy.


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