Resolution of status epilepticus after ketamine administration
Colleen Elizabeth Howing1, Farzad Razi2, Wael Hakmeh1
1Department of Emergency Medicine, Western Michigan University Homer Stryker M.D. School of Medicine, 1000 Oakland Drive, Kalamazoo, MI 49008, United States of America.
The American Journal of Emergency Medicine
|November 12, 2021
Summary
Ketamine may help refractory status epilepticus in children. This NMDA receptor antagonist offers a potential new treatment option when standard therapies fail, warranting further investigation.
Area of Science:
- Pediatric Neurology
- Emergency Medicine
- Pharmacology
Background:
- Status epilepticus is a critical pediatric neurological emergency.
- Current treatment algorithms involve benzodiazepines, Levetiracetam, Valproic Acid, Fosphenytoin, and high-dose Propofol.
- Refractory cases often require advanced airway management and sedation.
Observation:
- A 9-month-old girl presented with a 45-minute refractory generalized seizure.
- Multiple first- and second-line antiepileptic drugs were administered without success.
- Ketamine was administered due to its NMDA receptor antagonist properties.
Findings:
- Ketamine administration resulted in the cessation of seizure activity.
- Electroencephalogram (EEG) confirmed no ongoing seizure pattern post-treatment.
- The patient recovered to baseline within one week.
Implications:
- Ketamine may serve as a third or fourth-line agent for refractory status epilepticus in children.
- Its NMDA receptor blockade mechanism presents a novel therapeutic approach.
- Emergency physicians should consider ketamine in intubation protocols and refractory seizure management.
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