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Hypothermia and barbiturate coma for refractory status epilepticus.
Critical Care Medicine
|April 1, 1984
Summary
Moderate hypothermia and barbiturate coma effectively treated pediatric status epilepticus unresponsive to standard therapies. This approach offers a viable alternative to general anesthesia in intensive care units.
Area of Science:
- Pediatric Neurology
- Critical Care Medicine
- Pharmacology
Background:
- Status epilepticus in children poses significant treatment challenges.
- Conventional anticonvulsants are often ineffective in refractory cases.
Observation:
- Three pediatric patients with refractory generalized status epilepticus were treated.
- The treatment involved moderate hypothermia (30-31°C) and thiopental-induced barbiturate coma.
Findings:
- Therapy successfully controlled status epilepticus in all three patients.
- Continuous thiopental infusions maintained burst suppression on EEG at plasma levels of 25-40 mg/dL.
- Treatment duration ranged from 48 to 120 hours with total doses of 15-50g.
Implications:
- Moderate hypothermia combined with barbiturate coma is a promising treatment for refractory status epilepticus.
- This regimen can be managed in an ICU setting without volatile anesthetic agents.
- This approach provides an alternative for severe pediatric epilepsy cases.