title: Hypothermia for pediatric refractory status epilepticus.
abstract: OBJECTIVE
  Refractory status epilepticus (RSE) is a life-threatening emergency, demonstrating, by definition, significant pharmacoresistance. We describe five cases of pediatric RSE treated with mild hypothermia.
  
  
  METHODS
  Retrospective chart review was performed of records of children who received hypothermia for RSE at two tertiary-care pediatric hospitals between 2009 and 2012.
  
  
  RESULTS
  Five children with RSE received mild hypothermia (32-35°C). Hypothermia reduced seizure burden during and after treatment in all cases. Prior to initiation of hypothermia, four children (80%) received pentobarbital infusions to treat RSE, but relapsed after pentobarbital discontinuation. No child relapsed after treatment with hypothermia. One child died after redirection of care. Remaining four children were discharged.
  
  
  CONCLUSIONS
  This is the largest pediatric case series reporting treatment of RSE with mild hypothermia. Hypothermia decreased seizure burden during and after pediatric RSE and may prevent RSE relapse.
authors.affiliation: Division of Pediatric and Developmental Neurology, Department of Neurology, Washington University in St. Louis, St. Louis, Missouri, USA. guilliamsk@neuro.wustl.edu
authors.forename: Kristin
authors.initials: K
authors.lastname: Guilliams
authors.forename: Max
authors.initials: M
authors.lastname: Rosen
authors.forename: Sandra
authors.initials: S
authors.lastname: Buttram
authors.forename: John
authors.initials: J
authors.lastname: Zempel
authors.forename: Jose
authors.initials: J
authors.lastname: Pineda
authors.forename: Barbara
authors.initials: B
authors.lastname: Miller
authors.forename: Michael
authors.initials: M
authors.lastname: Shoykhet
mesh_terms: D000293:Adolescent; D002648:Child; D004569:Electroencephalography / Q000379:methods; D005260:Female; D006801:Humans; D007036:Hypothermia, Induced; D007223:Infant; D008297:Male; D010424:Pentobarbital / Q000627:therapeutic use; D012189:Retrospective Studies; D055502:Secondary Prevention; D012640:Seizures / Q000628:therapy*; D013226:Status Epilepticus / Q000628:therapy*; D016896:Treatment Outcome
chemical_list: D010424:Pentobarbital
keywords: Children; Cooling; Pharmacoresistance; Seizures
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