Abdominal Compartment Syndrome with Super-K (Ketamine) for Super-R(efractory) Status Epilepticus: A Case Report

Area of Science:

• Neurology
• Critical Care Medicine

Background:

• Refractory status epilepticus (RSE) is defined as status epilepticus unresponsive to initial treatments.
• Super-refractory status epilepticus (SRSE) persists despite anesthetic management for at least 24 hours.
• Evidence for SRSE management is limited, prompting exploration of novel therapies.

Observation:

• Ketamine has emerged as a promising unconventional therapy for SRSE, with reported efficacy up to 91% in cessation.
• This report details a case of a 74-year-old male with new-onset SRSE treated with ketamine infusion.
• The patient developed severe abdominal compartment syndrome during ketamine therapy.

Findings:

• Ketamine, while effective for SRSE, has known side effects like nausea, vomiting, headache, and hallucinations.
• Abdominal compartment syndrome has not been previously linked to ketamine's use in SRSE management.
• This case introduces abdominal compartment syndrome as a potential, albeit rare, complication of ketamine infusion for SRSE.

Implications:

• Increased awareness of potential ketamine-induced complications in SRSE management is crucial.
• Clinicians should consider abdominal compartment syndrome in patients receiving ketamine for SRSE who present with related symptoms.
• Further research is needed to elucidate the mechanism and incidence of this adverse event.