title: Effectiveness of Electroconvulsive Therapy for Refractory Status Epilepticus in Febrile Infection-Related Epilepsy Syndrome.
abstract: Febrile infection-related epilepsy syndrome (FIRES) is a rare condition which evolves into refractory status epilepticus (SE), with poor outcome in most cases. Conventional antiepileptic drugs fail to control SE in FIRES patients. We report the case of a previously healthy 4-year-old boy who was diagnosed with FIRES. One week after pharyngitis and high fever he started seizures, followed by refractory SE. Benzodiazepines, phenytoin, high-dose barbiturates that induce burst suppression, high doses of corticosteroids, plasmapheresis, immunoglobulins, propofol, lidocaine, ketamine, inhaled desflurane, ketogenic diet, lacosamide, and therapeutic hypothermia were tried at different times in a period of 8 weeks, but all of them were ineffective. Electroconvulsive therapy (ECT) has been used in refractory SE in children. We report a case in which ECT was successfully used for treatment of refractory SE in a pediatric patient with FIRES syndrome.
authors.affiliation: Department of Pediatric Intensive Care Unit, Hospital Universitario de Burgos, Burgos, Spain.
authors.forename: Alicia
authors.initials: A
authors.lastname: Mirás Veiga
authors.affiliation: Department of Pediatric Neurology, Hospital Universitario de Burgos, Burgos, Spain.
authors.forename: David Conejo
authors.initials: DC
authors.lastname: Moreno
authors.affiliation: Department of Neurophysiology, Hospital Universitario de Burgos, Burgos, Spain.
authors.forename: Ana Isabel Gómez
authors.initials: AI
authors.lastname: Menéndez
authors.affiliation: Department of Psychiatry, Hospital Universitario de Burgos, Burgos, Spain.
authors.forename: Ignacio Muñoz
authors.initials: IM
authors.lastname: Siscart
authors.affiliation: Department of Pediatrics, Hospital Río Carrión, Palencia, Spain.
authors.forename: Marta Del Olmo
authors.initials: MD
authors.lastname: Fernández
authors.affiliation: Department of Pediatric Intensive Care Unit, Hospital Universitario de Burgos, Burgos, Spain.
authors.forename: Esteban Gómez
authors.initials: EG
authors.lastname: Sánchez
authors.affiliation: Department of Pediatric Intensive Care Unit, Hospital Universitario de Burgos, Burgos, Spain.
authors.forename: María García
authors.initials: MG
authors.lastname: González
authors.affiliation: Department of Pediatric Intensive Care Unit, Hospital Universitario de Burgos, Burgos, Spain.
authors.forename: Fernando Gómez
authors.initials: FG
authors.lastname: Sáez
mesh_terms: D000071072:Acute Febrile Encephalopathy / Q000150:complications*; D000927:Anticonvulsants / Q000627:therapeutic use; D002675:Child, Preschool; D004565:Electroconvulsive Therapy / Q000379:methods*; D004569:Electroencephalography; D006801:Humans; D008297:Male; D013226:Status Epilepticus / Q000134:cerebrospinal fluid / Q000209:etiology* / Q000628:therapy*
chemical_list: D000927:Anticonvulsants