title: Prolonged pentobarbital-induced coma for the treatment of severe seizures related to posterior reversible encephalopathy syndrome.
abstract: In this report, we describe a case of posterior reversible encephalopathy syndrome in a female patient after deceased donor liver transplantation. She developed posterior reversible encephalopathy syndrome on postoperative day 3 and did not improve despite adjustments in immunosuppressive therapy. The patient had symptoms of severe brain edema requiring maximal therapy, which included cooling, mannitol, 3% saline, and a pentobarbital infusion. Attempts to lighten the level of sedation failed because of recurring intractable seizure activity. Reductions in therapeutic support were ultimately successful after 62 days of continuous pentobarbital therapy. The patient awoke neurologically intact and was discharged to a rehabilitation center in good condition.
authors.affiliation: From the *Department of Anesthesiology, †Department of Transplant Surgery, Penn State University, College of Medicine, Hershey Medical Center, Hershey, Pennsylvania; and ‡Department of Anesthesiology, University of Michigan, Ann Arbor, Michigan.
authors.forename: Elviira
authors.initials: E
authors.lastname: Corsi
authors.forename: Subramanian
authors.initials: S
authors.lastname: Sathishkumar
authors.forename: Riaz Ali
authors.initials: RA
authors.lastname: Shah
authors.forename: Zakiyah
authors.initials: Z
authors.lastname: Kadry
authors.forename: Patrick M
authors.initials: PM
authors.lastname: McQuillan
authors.forename: Sonia J
authors.initials: SJ
authors.lastname: Vaida
authors.forename: Dmitri S
authors.initials: DS
authors.lastname: Bezinover