title: Therapeutic plasma exchange for malignant refractory status epilepticus: a case report.
abstract: BACKGROUND
  Refractory status epilepticus is a prolongation of status epilepticus despite anticonvulsant therapy with two or three medications in proper doses; it is defined as malignant status epilepticus if it takes weeks or months. Intravenous immunoglobulin, high-dose steroids, magnesium infusion, pyridoxine, hypothermia, ketogenic diet, electroconvulsive therapy, and surgical therapy are the other treatment options for status epilepticus.
  
  
  METHODS
  Our 5-year-old male patient was hospitalized at our pediatric intensive care unit because of status epilepticus secondary to meningoencephalitis. No response could be obtained with many medical and nonmedical therapies in our patient, who developed malignant status epilepticus with unknown etiology. Therapeutic plasma exchange was applied as convulsions continued.
  
  
  RESULTS
  Ours is the first child for whom therapeutic plasma exchange was successfully applied because of malignant refractory status epilepticus secondary to meningoencephalitis.
  
  
  CONCLUSIONS
  Therapeutic plasma exchange may be a treatment option for children with refractory status epilepticus following presumed meningoencephalitis.
authors.affiliation: Department of Pediatrics, Faculty of Medicine, Bezmialem Vakıf University, Istanbul, Turkey. Electronic address: ahakangedik@hotmail.com.
authors.forename: Ahmet H
authors.initials: AH
authors.lastname: Gedik
authors.affiliation: Department of Pediatric Intensive Care, Faculty of Medicine, Bezmialem Vakıf University, Istanbul, Turkey.
authors.forename: Demet
authors.initials: D
authors.lastname: Demirkol
authors.affiliation: Department of Pediatric Neurology, Faculty of Medicine, Bezmialem Vakıf University, Istanbul, Turkey.
authors.forename: Burak
authors.initials: B
authors.lastname: Tatlı
authors.affiliation: Department of Pediatric Intensive Care, Faculty of Medicine, Bezmialem Vakıf University, Istanbul, Turkey.
authors.forename: Suleyman
authors.initials: S
authors.lastname: Bayraktar
authors.affiliation: Department of Radiology, Faculty of Medicine, Bezmialem Vakıf University, Istanbul, Turkey.
authors.forename: Alpay
authors.initials: A
authors.lastname: Alkan
authors.affiliation: Department of Pediatric Intensive Care, Faculty of Medicine, Bezmialem Vakıf University, Istanbul, Turkey.
authors.forename: Metin
authors.initials: M
authors.lastname: Karabocuoglu
authors.affiliation: Department of Pediatric Neurology, Faculty of Medicine, Bezmialem Vakıf University, Istanbul, Turkey.
authors.forename: Adnan
authors.initials: A
authors.lastname: Yuksel
mesh_terms: D001921:Brain / Q000473:pathology; D002675:Child, Preschool; D003937:Diagnosis, Differential; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008590:Meningoencephalitis / Q000150:complications* / Q000175:diagnosis / Q000473:pathology; D010951:Plasma Exchange; D013226:Status Epilepticus / Q000175:diagnosis / Q000209:etiology* / Q000473:pathology / Q000628:therapy*
keywords: children; convulsion; malignant status epilepticus; plasma exchange