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Calcium-channel blocker verapamil administration in prolonged and refractory status epilepticus

Paola Iannetti1, Alberto Spalice, Pasquale Parisi

  • 1Division of Child Neurology, Department of Paediatrics, University La Sapienza 2, Rome, Italy. paola.iannetti@uniroma1.it

Epilepsia
|June 11, 2005
PubMed

Insights

Intravenous verapamil successfully treated refractory status epilepticus (SE) in a child unresponsive to standard drugs. Verapamil

Area of Science:

  • Neurology
  • Pharmacology

Background:

  • Refractory status epilepticus (SE) poses a significant treatment challenge, often unresponsive to conventional antiepileptic drugs (AEDs).
  • Verapamil, a calcium channel blocker, has demonstrated anticonvulsant properties in preclinical animal models.

Observation:

  • An 11-year-old boy with refractory SE, unresponsive to standard AEDs, presented with supraventricular tachycardia.
  • Intravenous verapamil was administered due to its potential anticonvulsant activity and the patient's cardiac condition.

Findings:

  • A dramatic resolution of electrical SE and clinical improvement, including regained consciousness and spontaneous respiration, was observed after verapamil administration.
  • The patient received a cumulative dose of 3.125 mg of verapamil over 1.5 hours.

Implications:

  • Verapamil may represent a novel therapeutic option for refractory SE, potentially acting via direct anticonvulsant mechanisms involving calcium channels.
  • Verapamil's P-glycoprotein inhibitory effect could enhance the brain penetration of concurrently administered AEDs, improving their efficacy in SE treatment.

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