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Published on: November 13, 2016
Intravenous ketamine in status epilepticus
1Department of Neurology, Paracelsus Medical University Salzburg and Christian Doppler Medical Center, Salzburg, Austria.
Ketamine (KET) shows promise for treating refractory status epilepticus (SE) when other drugs fail. This review of 25 studies found KET effective in 73-74% of cases, with rare adverse events, but more research is needed.
Area of Science:
- Neurology
- Pharmacology
Background:
- Status epilepticus (SE) is a common neurological emergency.
- Refractory SE involves maladaptive cellular changes and increased NMDA receptor activity.
- Standard treatments may become ineffective in refractory SE.
Purpose of the Study:
- To systematically review and analyze published studies on ketamine (KET) for SE treatment.
- To evaluate the efficacy and safety of KET in managing refractory SE.
- To identify gaps in current research regarding KET for SE.
Main Methods:
- Systematic literature search of PubMed (December 1996 - March 2017).
- Included 25 studies: mostly retrospective case reports and series, with two prospective case series.
- Analyzed data from 244 SE episodes treated with KET in adults and children.
Main Results:
- Overall success rate for KET in SE was 74% in adults and 73% in children.
- Adverse events associated with KET treatment were reported as rare.
- Evidence primarily consists of low-level evidence (case reports/series).
Conclusions:
- Ketamine (KET) demonstrates potential as a treatment for refractory status epilepticus (SE).
- Current evidence is largely based on retrospective data, necessitating further investigation.
- Prospective studies are required to confirm KET's efficacy and safety in SE management.
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