Nair Pradeep Pankajakshan, Wadwekar Vaibhav, Murgai Aditya, Narayan Sunil K
Department of Neurology, Jawaharlal Institute of Postgraduate Medical Education & Research, Pondicherry, India.
BMJ Case Rep. 2014 Feb 11;2014:bcr-2013-202691. doi: 10.1136/bcr-2013-202691.
New onset refractory status epilepticus (NORSE) is a neurological emergency and difficult to treat condition. We report a case of involuntary movements resulting from thiopentone sodium infusion during the management of refractory status epilepticus. A young woman was admitted with fever and NORSE in the neurology intensive care unit. In addition to supportive measures, she was treated with intravenous lorazepam, phenytoin sodium, sodium valproate, midazolam and thiopentone sodium. While on thiopentone sodium, she developed involuntary twitches involving her upper limbs and face with EEG showing no evidence of ongoing status epilepticus. Because of the temporal relationship with thiopentone infusion, we tapered the dose of thiopentone sodium, which resulted in the disappearance of the movements. The patient recovered well with no recurrence of the seizures during the hospital stay.
新发难治性癫痫持续状态（NORSE）是一种神经系统急症，治疗困难。我们报告一例在难治性癫痫持续状态治疗期间因硫喷妥钠输注导致的不自主运动病例。一名年轻女性因发热和NORSE入住神经内科重症监护病房。除了支持性措施外，她接受了静脉注射劳拉西泮、苯妥英钠、丙戊酸钠、咪达唑仑和硫喷妥钠治疗。在使用硫喷妥钠期间，她出现了上肢和面部的不自主抽搐，脑电图显示无持续癫痫持续状态的证据。由于与硫喷妥钠输注存在时间关系，我们逐渐减少了硫喷妥钠的剂量，这导致运动消失。患者恢复良好，住院期间癫痫未复发。
