Abstract Details

Title Good Outcomes Possible after a Prolonged Course of Refractory Status Epilepticus

Topic Epilepsy

Presentation(s) P01 - (-)

Poster/Presentation
Number 048

Objective

Background Despite the large number of cases of status epilepticus (SE) there are no population based studies that have identified any unique clinical or diagnostic characteristics of an adult status epilepticus "survivor profile", and overall adult mortality remains high at 26%.

Design/Methods An extensive chart review with focus on anti-epileptic drug therapy, the use of continuous electroencephalogram monitoring, work-up for secondary causes, imaging studies, and decision making processes as it related to continued care was detailed. The most current literature was reviewed to determine if there was an optimal treatment strategy and "survivor prorile" that could be used to direct future cases of prolonged refractory SE cases.

Results Continuous infusions with phenobarbital, ketamine, and midazolam were used throughout the course of treatment. A combination of 8 anti-epileptic medications were used to abort the seizures. The patient was given a trial of methylprednisolone, intravenous immunoglobulin, and ketogenic diet. Infectious disease and paraneoplastic work-up was negative. A literature search revealed 4 studies which encompass a review of 10 adult patients however, morbidity and mortality were high in all the patients.

Conclusions There are reports of patients surviving prolonged treatment of refractory SE but typically outcomes are poor. Determining the prognosis for functional recovery and deciding on adequate treatment duration can be difficult in cases of refractory SE. This case illustrates treatment strategies that resulted in a good functional recovery even after months of refractory SE.

Authors/Disclosures
Katherine Standley, DO PRESENTER	No disclosure on file
Gary R. Cutter, PhD (University of Alabama At Birmingham)	Dr. Cutter has received personal compensation in the range of $50,000-$99,999 for serving as a Consultant for onsulting or Advisory Boards: Alexion, Antisense Therapeutics/Percheron, Avotres, Biogen, Clene Nanomedicine, Clinical Trial Solutions LLC, Endra Life Sciences, Cognito Therapeutics, Genzyme, Genentech, Immunic, Klein-Buendel Incorporated, Kyverna Therapeutics, Inc. , Linical, Merck/Serono, Noema, Neurogenesis, Perception Neurosciences, Protalix Biotherapeutics, Regeneron, Revelstone Consulting, Roche, SAB Biotherapeutics, Sapience Therapeutics, Scott&Scott LLP, Tenmile.. Dr. Cutter has received personal compensation in the range of $50,000-$99,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Data and Safety Monitoring Boards: Applied Therapeutics, AI therapeutics, AMO Pharma, Argenx, Astra-Zeneca, Avexis Pharmaceuticals, Bristol Meyers Squibb, CSL Behring, Cynata Therapeutics, DiamedicaTherapeutics, Horizon Pharmaceuticals, Immunic, Inhibrix, Karuna Therapeutics, Kezar Life Sciences, Medtronic, Merck, Meiji Seika Pharma, Mitsubishi Tanabe Pharma Holdings, Prothena Biosciences, Novartis, Pipeline Therapeutics (Contineum), Regeneron, Sanofi-Aventis, Teva Pharmaceuticals, United BioSource LLC, University of Texas Southwestern.. Dr. Cutter has received personal compensation in the range of $5,000-$9,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for JASN.
Selim R. Benbadis, MD, FAAN (University of South Florida)	Dr. Benbadis has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Stratus. Dr. Benbadis has received personal compensation in the range of $50,000-$99,999 for serving on a Speakers Bureau for SK Lifesciences. Dr. Benbadis has received personal compensation in the range of $50,000-$99,999 for serving on a Speakers Bureau for Jazz. Dr. Benbadis has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Catalyst. Dr. Benbadis has received personal compensation in the range of $50,000-$99,999 for serving on a Speakers Bureau for Neurelis. Dr. Benbadis has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Sunovion. Dr. Benbadis has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Livanova. Dr. Benbadis has received personal compensation in the range of $50,000-$99,999 for serving on a Speakers Bureau for UCB.

��ɫ��

��ɫ��