Stetefeld, Henning R. and Schaal, Alexander and Scheibe, Franziska and Nichtweiss, Julia and Lehmann, Felix and Mueller, Marcus and Gerner, Stefan T. and Huttner, Hagen B. and Luger, Sebastian and Fuhrer, Hannah and Boesel, Julian and Schoenenberger, Silvia and Dimitriadis, Konstantinos and Neumann, Bernhard and Fuchs, Kornelius and Fink, Gereon R. and Malter, Michael P. (2021) Isoflurane in (Super-) Refractory Status Epilepticus: A Multicenter Evaluation. NEUROCRITICAL CARE, 35 (3). pp. 631-639. ISSN 1541-6933, 1556-0961
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Background We aimed to determine the association between seizure termination and side effects of isoflurane for the treatment of refractory status epilepticus (RSE) and super-refractory status epilepticus (SRSE) in neurointensive care units (neuro-ICUs). Methods This was a multicenter retrospective study of patients with RSE/SRSE treated with isoflurane for status epilepticus termination admitted to the neuro-ICUs of nine German university centers during 2011-2018. Results We identified 45 patients who received isoflurane for the treatment of RSE/SRSE. During isoflurane treatment, electroencephalograms showed no epileptiform discharges in 33 of 41 (80%) patients, and burst suppression pattern was achieved in 29 of 41 patients (71%). RSE/SRSE was finally terminated after treatment with isoflurane in 23 of 45 patients (51%) for the entire group and in 13 of 45 patients (29%) without additional therapy. Lengths of stay in the hospital and in the neuro-ICU were significantly extended in cases of ongoing status epilepticus under isoflurane treatment (p = 0.01 for length of stay in the hospital, p = 0.049 for length in the neuro-ICU). During isoflurane treatment, side effects were reported in 40 of 45 patients (89%) and mainly included hypotension (n = 40, 89%) and/or infection (n = 20, 44%). Whether side effects occurred did not affect the outcome at discharge. Of 22 patients with follow-up magnetic resonance imaging, 2 patients (9%) showed progressive magnetic resonance imaging alterations that were considered to be potentially associated with RSE/SRSE itself or with isoflurane therapy. Conclusions Isoflurane was associated with a good effect in stopping RSE/SRSE. Nevertheless, establishing remission remained difficult. Side effects were common but without effect on the outcome at discharge.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | CONVULSIVE STATUS EPILEPTICUS; MORTALITY; PREDICTORS; THERAPIES; SEDATION; SCORE; Status epilepticus; Isoflurane; Epilepsy |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Neurologie |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 23 Sep 2022 05:25 |
| Last Modified: | 23 Sep 2022 05:25 |
| URI: | https://pred.uni-regensburg.de/id/eprint/47899 |
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