title: Intravenous ketamine for treatment of super-refractory convulsive status epilepticus with septic shock: A report of two cases.
abstract: Refractory and super-refractory status epilepticus is a life-threatening neurological emergency, associated with high morbidity and mortality. Treatment should be aimed to stop seizure and to avoid cerebral damage and another morbidity. Published data about effectiveness, safety and outcome of various therapies and treatment approaches are sparse and are mainly based on small case series and retrospective data. Here we report successful management of two cases of super-refractory status epilepticus refractory to anesthetic therapy with midazolam and complicated by septic shock, managed successfully with ketamine infusion.
authors.affiliation: Department of Anaesthesiology, Institute of Medicine, Tribhuvan University Teaching Hospital, Kathmandu, Nepal.
authors.forename: Gentle Sunder
authors.initials: GS
authors.lastname: Shrestha
authors.affiliation: Department of Anaesthesiology, Institute of Medicine, Tribhuvan University Teaching Hospital, Kathmandu, Nepal.
authors.forename: Pankaj
authors.initials: P
authors.lastname: Joshi
authors.affiliation: Department of Internal Medicine, Institute of Medicine, Tribhuvan University Teaching Hospital, Kathmandu, Nepal.
authors.forename: Santosh
authors.initials: S
authors.lastname: Chhetri
authors.affiliation: Department of Neurology, Institute of Medicine, Tribhuvan University Teaching Hospital, Kathmandu, Nepal.
authors.forename: Ragesh
authors.initials: R
authors.lastname: Karn
authors.affiliation: Department of Anaesthesiology, Institute of Medicine, Tribhuvan University Teaching Hospital, Kathmandu, Nepal.
authors.forename: Subhash Prasad
authors.initials: SP
authors.lastname: Acharya
keywords: Ketamine; septic shock; super-refractory status epilepticus