Epilepsy, Cleveland Clinic Foundation, Cleveland, OH, USA.
Neurology, Atrium Health Neuroscience Institute, Monroe, NC, USA.
Clin EEG Neurosci. 2024 Mar;55(2):230-234. doi: 10.1177/15500594221134920. Epub 2022 Oct 25.
Refractory status epilepticus is commonly defined as status epilepticus that fails to respond to two or more appropriately dosed intravenous anti-seizure medications including at least one non-benzodiazepine drug. Super-refractory status epilepticus (SRSE) is when status epilepticus continues for ≥24 h despite anesthetic treatment or recurs on an attempted wean of the anesthetic drugs. There is little evidence to guide the management of SRSE. Of late, unconventional therapies have been described in the literature regarding the management of SRSE, with ketamine leading the pack. Studies have noted ketamine's therapeutic efficacy up to 91% in SRSE cessation. Common side effects of ketamine include nausea, vomiting, headache, and hallucinations; but to our knowledge, ketamine has not been implicated in the pathogenesis of abdominal compartment syndrome. We describe a 74-year-old male who developed severe abdominal compartment syndrome in the setting of ketamine infusion for new-onset SRSE to increase awareness about this potential complication.
难治性癫痫持续状态通常定义为癫痫持续状态，对两种或两种以上剂量适当的静脉抗癫痫药物（包括至少一种非苯二氮䓬类药物）无反应。超难治性癫痫持续状态（SRSE）是指尽管进行了麻醉治疗，癫痫持续状态仍持续≥24 小时，或在试图停用麻醉药物时复发。几乎没有证据可以指导 SRSE 的治疗。最近，文献中描述了一些关于 SRSE 治疗的非常规疗法，其中氯胺酮是最常用的。研究表明，氯胺酮在停止 SRSE 方面的治疗效果高达 91%。氯胺酮的常见副作用包括恶心、呕吐、头痛和幻觉；但据我们所知，氯胺酮并未与腹腔间隔室综合征的发病机制有关。我们描述了一位 74 岁男性，他在新诊断的 SRSE 中接受氯胺酮输注以增加对这种潜在并发症的认识，在此背景下出现严重的腹腔间隔室综合征。
