Prüss Harald, Holtkamp Martin
Department of Neurology, Charité - Universitätsmedizin Berlin, Berlin, Germany.
Epilepsy Res. 2008 Dec;82(2-3):219-22. doi: 10.1016/j.eplepsyres.2008.08.005. Epub 2008 Sep 19.
A 22-year-old woman with mitochondriopathy and pre-existing epilepsy developed status epilepticus (SE) not responding to benzodiazepines, phenytoin, thiopental, and propofol. SE was terminated within days after supplemental administration of continuous ketamine infusion to midazolam. The case suggests strong anticonvulsant properties of ketamine even after failure of GABAergic anesthetics, likely due to increased NMDA receptor expression with ongoing seizure activity. Thus, ketamine should be incorporated into therapeutic regimens for difficult-to-treat SE.
一名患有线粒体病且既往有癫痫病史的22岁女性发生了癫痫持续状态（SE），对苯二氮䓬类药物、苯妥英钠、硫喷妥钠和丙泊酚均无反应。在咪达唑仑基础上补充持续输注氯胺酮数天内，SE得到控制。该病例表明，即使GABA能麻醉药治疗失败，氯胺酮仍具有强大的抗惊厥特性，这可能是由于持续的癫痫发作活动导致NMDA受体表达增加所致。因此，氯胺酮应纳入难治性SE的治疗方案中。
