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Can intravenous lorazepam prevent postictal generalized EEG suppression? A case report
Zack Ramilevich1, Katherine Zarroli1
1University of Florida, Jacksonville, FL, USA.
Clinical Neurophysiology Practice
|July 26, 2024
Summary
Postictal generalized electrographic suppression (PGES) is linked to sudden unexplained death in epilepsy (SUDEP). Benzodiazepines may prevent PGES, potentially lowering SUDEP risk.
Area of Science:
- Epilepsy research
- Neurophysiology
- Clinical neurology
Background:
- Postictal generalized electrographic suppression (PGES) is an electrophysiological marker.
- PGES is associated with an increased risk of sudden unexplained death in epilepsy (SUDEP).
Observation:
- A case study involved a young man with focal to bilateral tonic-clonic seizures.
- PGES was observed after two spontaneously-aborted seizures.
- PGES was absent after a third seizure, which was aborted by benzodiazepine administration.
Findings:
- The absence of PGES after benzodiazepine administration suggests a potential protective effect.
- Benzodiazepines may directly counteract the suppressive effects leading to PGES.
Implications:
- Acutely administered benzodiazepines might reduce SUDEP risk by preventing PGES.
- This finding warrants further investigation into benzodiazepine use for SUDEP prevention.
