title: Supra-recommendation Treatment of Super-refractory Status Epilepticus.
abstract: A 28-year old female was admitted with recurrent seizures following 2 days of febrile illness, after which she developed status epilepticus. Midazolam and later thiopentone infusions were started after failure of regular intravenous antiepileptics. Burst suppression was achieved at doses of 3 mg/kg/hr for midazolam and 6 mg/kg/hr of thiopentone. Adjunctive medications included methylprednisolone, intravenous immunoglobulin and acyclovir. Imaging and biochemical parameters were normal. She required 3 cycles of midazolam and 2 cycles of thiopentone for complete cessation of seizures. She recovered with mild attentional and recent memory deficits on follow up. Treatment of super-refractory status epilepticus requires individualized regimens and may need doses beyond conventional limits. To the best of our knowledge, there is no such reported case from India.
authors.affiliation: Department of Neurology, Narayana Institute of Neurosciences, Narayana Health City, Bangalore, India.
authors.forename: Devashish Dhiren
authors.initials: DD
authors.lastname: Vyas
authors.affiliation: Department of Neurology, Narayana Institute of Neurosciences, Narayana Health City, Bangalore, India.
authors.forename: Gopal Krishna
authors.initials: GK
authors.lastname: Dash
keywords: Anesthetic agents; Antiepileptics; Autoimmune; Status epilepticus; Treatment