Status epilepticus: divergence of sympathetic activity and cardiovascular response

To study changes in plasma catecholamine concentrations and their relationship to changes in systemic and pulmonary vascular pressures, we induced status epilepticus by intravenous administration of bicuculline in 5 anesthetized, paralyzed, ventilated adult sheep. Status epilepticus was accompanied by marked elevations in plasma epinephrine and norepinephrine levels (390-fold and 163-fold, respectively) and by marked elevations in systemic and pulmonary vascular pressures. Vascular pressure returned to normal in 60 minutes, despite plasma catecholamine levels that remained elevated for the 3-hour duration of the study. Mild metabolic acidosis and hyperkalemia were also noted. We discuss the implications of these findings with regard to the management of hypotension during status epilepticus.