Prolonged electrocerebral silent barbiturate coma in intractable seizure disorders.
Barbiturate coma (BC) is a known modality for terminating resistant convulsive status epilepticus. It is usually applied until seizure activity ends. We recently adopted a modified protocol of prolonged, electrocerebral silent BC to treat patients with chronic seizure activity resistant to multiple regimens of antiepileptic drugs. Four patients, aged 4 months to 10 years, with long-standing intractable generalized seizures were treated. Seizure frequency ranged from one to two to numerous times per day. Following BC, one patient has been seizure free during 8 months of follow-up, and another has had only two seizures in 18 months. A 4-month-old infant was seizure-free for 2 weeks after BC and then died from underlying CNS disease. A 10-year-old girl died during BC from shock and hyperpyrexia. The results obtained in our patients indicate that prolonged electrocerebral silent BC may exert a beneficial long-term effect in treatment of intractable seizure disorders. This procedure might also be beneficial in other forms of epilepsy.
Amit
R
R
Department of Pediatrics, Hadassah University Hospital, Jerusalem, Israel.
Goitein
K J
KJ
Mathot
I
I
Yatziv
S
S
D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease; D003128:Coma; D004569:Electroencephalography; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007262:Infusions, Intravenous; D007275:Injections, Intravenous; D008297:Male; D008722:Methods; D012640:Seizures / Q000503:physiopathology / Q000628:therapy*; D013874:Thiopental / Q000008:administration & dosage*; D013997:Time Factors
D013874:Thiopental