Oral ketamine in paediatric non-convulsive status epilepticus

Area of Science:

• Pediatric Neurology
• Epileptology
• Pharmacology

Background:

• Non-convulsive status epilepticus (NCSE) is a rare and challenging neurological emergency in children.
• Conventional treatments like steroids and GABAergic medications show variable efficacy, often diminishing with prolonged NCSE duration.

Purpose of the Study:

• To evaluate the efficacy and safety of oral ketamine as a treatment for NCSE in pediatric patients with severe epilepsy.

Main Methods:

• A case series involving five children diagnosed with severe epilepsy syndromes (Lennox-Gastaut Syndrome, myoclonic-astatic epilepsy, progressive myoclonic epilepsy, Pseudo-Lennox Syndrome).
• Oral ketamine, an NMDA-receptor antagonist, was administered during NCSE episodes.
• Clinical and electroencephalographic assessments were used to document treatment response.

Main Results:

• Complete resolution of NCSE was achieved in all five children within 24-48 hours of initiating oral ketamine therapy.
• No significant adverse effects were reported during the treatment period.

Conclusions:

• Oral ketamine demonstrates promising efficacy and a favorable safety profile for treating NCSE in children with severe epilepsy.
• Ketamine represents a potential therapeutic option for refractory pediatric NCSE.