Treatment of refractory complex-partial status epilepticus with propofol: case report.

Abstract

PURPOSE:

We report a case of a 65-year-old woman who had a subarachnoid and intraventricular hemorrhage secondary to rupture of an anterior communicating artery aneurysm and developed nonconvulsive status epilepticus of the complex-partial type, refractory to phenytoin (PHT), phenobarbital (PB), valproate (VPA), and lorazepam (LZP).

METHODS:

Three weeks after diagnosis of nonconvulsive status epilepticus, general anesthesia was induced with propofol and titrated to burst suppression on the electroencephalogram (EEG).

RESULTS:

During propofol infusion, the serum VPA level declined markedly, and despite >3 g daily doses, did not return to the therapeutic range, until several days after propofol was discontinued. Continuous propofol infusion was stopped after 7 days, and the patient recovered consciousness. Despite further complications, she gradually regained normal function and was discharged home 4 months after surgery.

CONCLUSIONS:

This is the first case of nonconvulsive status epilepticus successfully treated with propofol.

• Authors: M Begemann, A J Rowan, S Tuhrim
• Journal: Epilepsia (Epilepsia) Vol. 41 Issue 1 Pg. 105-9 (Jan 2000) ISSN: 0013-9580 [Print] United States
• PMID: 10643932 (Publication Type: Case Reports, Journal Article)

Chemical References

• Anticonvulsants
• Valproic Acid
• Propofol

Topics

• Aged
• Anticonvulsants (blood, therapeutic use)
• Drug Interactions
• Drug Resistance, Multiple
• Electroencephalography (drug effects)
• Epilepsy, Complex Partial (blood, drug therapy, physiopathology)
• Female
• Humans
• Propofol (blood, therapeutic use)
• Status Epilepticus (blood, drug therapy, physiopathology)
• Valproic Acid (blood, therapeutic use)