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Palliative sedation for status epilepticus in a patient with progressive multifocal leukoencephalopathy
Abstract:
Palliative sedation is defined as the use of sedative drugs in order to reduce the patient's consciousness in case of refractory symptoms. The most used drug is midazolam, a benzodiazepine with a short half-life administered either intravenously or subcutaneously. We discuss on a clinical case requiring an exceptionally high dosage of midazolam-up to 160 mg iv daily-to achieve palliative sedation. The patient was an HIV positive 29-year-old male who was suffering from progressive multifocal leukoencephalopathy complicated by a refractory status epilepticus and who was suspected of previous benzodiazepines and opioid abuse. In such situations of a suffering brain doses of midazolam to achieve symptom control may be much higher than expected.
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