Repetitive synchronized cyclical oscillations of multisystem parameters subsequent to high-dose thiopental therapy for status epilepticus secondary to herpes encephalitis.
We report a case of status epilepticus secondary to herpes encephalitis, treated with thiopental infusion and mechanical ventilation. The computerized storage and analysis of physiological data led to the detection of repetitive synchronized cyclical oscillations of arterial pressure, heart rate, EEG parameters, peripheral temperature and core temperature. Arterial pressure oscillations have been described in patients who are severely systemically unwell; cardiovascular and brain electrical activity may also oscillate in the presence of raised intracranial pressure. In contrast, this patient had no features of severe systemic illness or of raised intracranial pressure. Our hypothesis is that high-dose thiopental may have been a cause of our findings by producing autonomic dysfunction.
Ghosh
I R
IR
Department of Clinical Neurophysiology, St Bartholomew's Hospital, London, UK.
Langford
R M
RM
Nieminen
K
K
Kari
A
A
Takala
J
J
D000293:Adolescent; D018686:Anesthetics, Intravenous / Q000009:adverse effects* / Q000627:therapeutic use; D001794:Blood Pressure / Q000187:drug effects / Q000502:physiology; D001831:Body Temperature / Q000187:drug effects / Q000502:physiology; D003422:Critical Care / Q000379:methods; D004562:Electrocardiography; D004569:Electroencephalography / Q000187:drug effects; D020803:Encephalitis, Herpes Simplex / Q000150:complications* / Q000503:physiopathology; D006339:Heart Rate / Q000187:drug effects / Q000502:physiology; D014645:Herpesvirus 3, Human / Q000302:isolation & purification; D006801:Humans; D008297:Male; D008991:Monitoring, Physiologic / Q000379:methods; D010507:Periodicity; D013226:Status Epilepticus / Q000188:drug therapy / Q000503:physiopathology* / Q000821:virology; D013874:Thiopental / Q000009:adverse effects* / Q000627:therapeutic use
D018686:Anesthetics, Intravenous; D013874:Thiopental