[Experience in managing refractory status epilepticus caused by viral encephalitis under long-term anesthesia with...

This is a case study in managing refractory status epilepticus under long-term usage of secobarbital (SB). The patient is a 26-year-old woman with viral encephalitis. Fifteen days after the onset of the disease, status epilepticus with complex partial seizures began. The seizures were so refractory to conventional anti-epileptic drugs, such as valproate, carbamazepine, phenytoin, phenobarbital, clonazepam, lorazepam and lidocaine, that we had to put her on anesthesia with SB for approximately 10 months. Finally, we stopped the administration of SB and support for ventilation; we reduced the dose of SB extremely slowly, using zonisamide at the same time. After trial and error, we found that a reduction of the dosage after long-term anesthesia with high-dose administrations of barbiturate should be made very slowly.