Sanghita Layek*, Rahul Ghiya, Suparna Chatterjee and Bibhukalyani Das

Department of Neurocritical Care, Institute of Neurosciences Kolkata, India

*Corresponding Author: Sanghita Layek, Department of Neurocritical Care, Institute of Neurosciences Kolkata, India.

Received: October 28, 2024; Published: November 29, 2024

Abstract

Introduction: Super-refractory status epilepticus refers to drug-resistant status epilepticus that persists or recurs following the continuous administration of intravenous anesthetics for more than 24 hours or when tapered after 24 hours. Ketamine could play an important role in terminating such seizures.

Methodology: This retrospective observational study was conducted in a tertiary care Neurosciences hospital of eastern India. Records of patients of refractory status epilepticus (SE) who received ketamine and underwent scalp EEG/ continuous EEG in the intensive therapy unit were reviewed and their clinical, detailed treatment and investigation records were analysed. Records of patients admitted from 2019 to 2023 with a diagnosis of super-refractory status epilepticus (SRSE) were screened. There were 14 cases of SRSE who received ketamine infusion. Seizure control (both clinical and/or electroencephalographic), cardiovascular and intracranial haemodynamic parameters, and final outcome of the patients were analysed.

Results: Majority had new onset SE of varying etiology and were treated with antiseizure medications prior to anesthetic drug administration. The median ketamine infusion dose was 5mg/kg/hr and duration ranged from 1-30 days. All required mechanical ventilation and 71.4% were on vasopressor support. Combination of ketamine and low dose midazolam effectively suppressed epileptic discharges and improved haemodynamic stability in 42.9 % cases. Except for two patients who had associated sepsis, the rest had a favorable outcome.

 Conclusion: This study has generated data about the effectiveness and safety of ketamine in controlling seizures in a cohort of SRSE patients. However, further studies are required to establish its efficacy and safety.

 Keywords: Super Refractory Status Epilepticus; Ketamine; Effectiveness; Safety; Observational Study

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Citation

Citation: Sanghita Layek., et al. “Ketamine in Refractory and super-refractory seizures: a Retrospective Observational Study”. Acta Scientific Neurology 7.12 (2024): 52-57.

Copyright

Copyright: © 2024 Sanghita Layek., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.