Article

Prolonged coma from refractory status epilepticus.

Critical Care Service, Mayo Clinic College of Medicine, Rochester, MN 55905, USA.
Neurocritical Care (impact factor: 2.47). 02/2006; 4(2):140-2. DOI:10.1385/NCC:4:2:140 pp.140-2
Source: PubMed

ABSTRACT Status epilepticus is a life-threatening medical condition. In its most severe form, refractory status epilepticus (RSE) seizures may not respond to first and second-line anti-epileptic drugs. RSE is associated with a high mortality and significant medical complications in survivors with prolonged hospitalizations.
We describe the clinical course of RSE in the setting of new onset lupus in a 31-year-old male who required prolonged barbiturate coma.
Seizure stopped on day 64 of treatment. Prior to the resolution of seizures, discussion around withdrawal of care took place between the physicians and patient's family. Medical care was continued because of the patient's age, normal serial MRI studies, and the patient's reversible medical condition.
Few evidence-based data exist to guide management of RSE. Our case emphasizes the need for continuous aggressive therapy when neuroimaging remains normal.

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Keywords

31-year-old male
 
barbiturate coma
 
case emphasizes
 
continuous aggressive therapy
 
evidence-based data
 
guide management
 
hospitalizations
 
new onset lupus
 
normal serial MRI studies
 
patient's age
 
patient's family
 
patient's reversible medical condition
 
refractory status epilepticus
 
second-line anti-epileptic drugs
 
severe form
 
significant medical complications
 
Status epilepticus