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Hypothermia as an adjuvant treatment in paediatric refractory or super-refractory status epilepticus

Stephane Legriel1,2,3

  • 1Medico-Surgical Intensive Care Department, Centre Hospitalier de Versailles, Le Chesnay, France.

Developmental Medicine and Child Neurology
|May 16, 2020
PubMed

Insights

Therapeutic hypothermia shows promise for pediatric refractory status epilepticus, reducing seizures. However, recurrences are common after rewarming, necessitating further research into optimal use.

Area of Science:

  • Pediatric Neurology
  • Critical Care Medicine
  • Neuroscience

Background:

  • Refractory or super-refractory status epilepticus (R/SR-SE) in children requires effective adjuvant therapies.
  • Therapeutic hypothermia (TH) demonstrates neuroprotective and antiseizure properties in experimental models.
  • Limited data exists on TH application in pediatric R/SR-SE.

Purpose of the Study:

  • To review the evidence for therapeutic hypothermia in pediatric R/SR-SE.
  • To evaluate the efficacy and safety of TH in this patient population.

Main Methods:

  • Review of experimental studies on hypothermia in status epilepticus.
  • Analysis of reported cases of therapeutic hypothermia in pediatric R/SR-SE.

Main Results:

  • Experimental hypothermia (20°C–33°C) reduces neuronal damage and seizure activity in animal models.
  • In pediatric R/SR-SE, TH significantly improves seizure control.
  • Recurrences of seizures after rewarming were observed in nearly half of the treated children.

Conclusions:

  • Therapeutic hypothermia exhibits significant antiseizure effects in pediatric R/SR-SE.
  • Further studies are required to establish optimal modalities and indications for TH in pediatric R/SR-SE.
  • The risk of seizure recurrence post-rewarming needs careful consideration and management strategies.

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