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A forgotten alternative: Bromides for refractory status epilepticus

Nir Horesh1, Marina Rubinstein1, Bruria Ben-Zeev1

  • 1Department of Pediatric Critical Care Medicine, Safra Children's Hospital, Sheba Medical Center, Tel Hashomer, affiliated with Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.

Journal of Pediatric Intensive Care
|June 20, 2019
PubMed

Insights

Potassium bromide effectively reduced seizures in two infants with severe, intractable epilepsy, including malignant migrating partial epilepsy of infancy and Ohtahara syndrome, when other treatments failed. This safe and rapid therapeutic option showed significant benefits with no apparent side effects.

Area of Science:

  • Pediatric Neurology
  • Epileptology
  • Clinical Pharmacology

Background:

  • Infantile epilepsy syndromes, such as malignant migrating partial epilepsy of infancy (MMPEI) and Ohtahara syndrome (OS), often present with severe, refractory status epilepticus.
  • Standard antiepileptic drugs (AEDs) frequently fail to control seizures in these challenging pediatric cases.

Observation:

  • Two infants, one with MMPEI and another with OS, experienced severe refractory status epilepticus.
  • Both infants had failed to respond to multiple conventional AEDs.

Findings:

  • Treatment with potassium bromide (KBr) resulted in a significant reduction in seizure frequency and duration in both patients.
  • Dosage augmentation of KBr was safely managed, leading to positive clinical outcomes.
  • No apparent adverse effects were observed during KBr treatment.

Implications:

  • Potassium bromide demonstrates significant efficacy and safety as a therapeutic option for infants with severe intractable seizures refractory to other AEDs.
  • This study supports considering KBr as a valuable treatment strategy in pediatric epilepsy when conventional therapies are insufficient.
  • Further research into KBr's role in managing refractory infantile epilepsy is warranted.

Keywords:
Bromidesantiepileptic drugspediatric intensive care unitrefractory status epilepticusseizure controlside effects

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