Ioku Tetsuya, Inoue Takeshi, Kuki Ichiro, Imai Keisuke, Yamamoto Atsushi, Cho Masanori
Department of Neurology and Stroke Treatment, Kyoto First Red Cross Hospital.
Child and Adolescent Epilepsy Center, Department of Pediatric Neurology, Osaka City General Hospital.
Rinsho Shinkeigaku. 2022 Feb 19;62(2):123-129. doi: 10.5692/clinicalneurol.cn-001624. Epub 2022 Jan 31.
A 16-year-old male was brought to the emergency room with fever and status epilepticus, and was diagnosed with febrile infection-related epilepsy syndrome (FIRES). Seizure control was not achieved and the patient developed multiple complications. Ketamine infusion therapy and intrathecal dexamethasone therapy were administered, in addition to other anti-seizure treatment and immunotherapy for super-refractory status epilepticus (SRSE). The patient was weaned from the ventilator on day 170 and was able to live at home, although he continued to experience monthly focal motor seizures and moderate motor impairment. This case suggests that more aggressive treatment might be an option in FIRES with prolonged SRSE.
一名16岁男性因发热和癫痫持续状态被送往急诊室，被诊断为发热感染相关癫痫综合征（FIRES）。癫痫发作未能得到控制，患者出现了多种并发症。除了针对超难治性癫痫持续状态（SRSE）的其他抗癫痫治疗和免疫治疗外，还给予了氯胺酮输注治疗和鞘内注射地塞米松治疗。患者在第170天脱机，能够在家生活，尽管他仍每月发作局灶性运动性癫痫，并存在中度运动障碍。该病例表明，对于伴有长期SRSE的FIRES，更积极的治疗可能是一种选择。
