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Electroconvulsive Therapy in Super Refractory Status Epilepticus: Case Series with a Defined Protocol

Super-refractory status epilepticus (SRSE) represents a neurological emergency that is characterized by a lack of response to the third line of antiepileptic treatment, including intravenous general anesthetics. It is a medical challenge with high morbidity and mortality. Electroconvulsive therapy (...

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Autores principales: García-López, Beatriz, Gómez-Menéndez, Ana Isabel, Vázquez-Sánchez, Fernando, Pérez-Cabo, Eva, Isidro-Mesas, Francisco, Zabalegui-Pérez, Arturo, Muñoz-Siscart, Ignacio, Lloria-Gil, María Carmen, Soto-Cámara, Raúl, González-Bernal, Jerónimo J., González-Santos, Josefa, Aguilar-Parra, José M., Trigueros, Rubén, López-Liria, Remedios, Kjær, Troels Wesenberg
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7312395/
https://www.ncbi.nlm.nih.gov/pubmed/32516983
http://dx.doi.org/10.3390/ijerph17114023
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author García-López, Beatriz
Gómez-Menéndez, Ana Isabel
Vázquez-Sánchez, Fernando
Pérez-Cabo, Eva
Isidro-Mesas, Francisco
Zabalegui-Pérez, Arturo
Muñoz-Siscart, Ignacio
Lloria-Gil, María Carmen
Soto-Cámara, Raúl
González-Bernal, Jerónimo J.
González-Santos, Josefa
Aguilar-Parra, José M.
Trigueros, Rubén
López-Liria, Remedios
Kjær, Troels Wesenberg
author_facet García-López, Beatriz
Gómez-Menéndez, Ana Isabel
Vázquez-Sánchez, Fernando
Pérez-Cabo, Eva
Isidro-Mesas, Francisco
Zabalegui-Pérez, Arturo
Muñoz-Siscart, Ignacio
Lloria-Gil, María Carmen
Soto-Cámara, Raúl
González-Bernal, Jerónimo J.
González-Santos, Josefa
Aguilar-Parra, José M.
Trigueros, Rubén
López-Liria, Remedios
Kjær, Troels Wesenberg
author_sort García-López, Beatriz
collection PubMed
description Super-refractory status epilepticus (SRSE) represents a neurological emergency that is characterized by a lack of response to the third line of antiepileptic treatment, including intravenous general anesthetics. It is a medical challenge with high morbidity and mortality. Electroconvulsive therapy (ECT) has been recommended as a nonpharmacologic option of treatment after other alternatives are unsuccessful. Its effect on the cessation of SRSE has been minimally investigated. The objective of this article is to analyze the effect of ECT on SRSE. For this purpose, a multidisciplinary team created a protocol based on clinical guidelines similar to those described previously by Ray et al. (2017). ECT was applied to six patients with SRSE after the failure of antiepileptic treatment and pharmacologic coma.The objective of each ECT session was to elicit a motor seizure for at least 20 s. SRSE was resolved in all patients after several days of treatment, including ECT as a therapy, without relevant adverse effects. Thus, ECT is an effective and feasible option in the treatment of SRSE, and its place in the algorithm in treatment should be studied due to the uncommon adverse effects and the noninvasive character of the therapy.
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spelling pubmed-73123952020-06-26 Electroconvulsive Therapy in Super Refractory Status Epilepticus: Case Series with a Defined Protocol García-López, Beatriz Gómez-Menéndez, Ana Isabel Vázquez-Sánchez, Fernando Pérez-Cabo, Eva Isidro-Mesas, Francisco Zabalegui-Pérez, Arturo Muñoz-Siscart, Ignacio Lloria-Gil, María Carmen Soto-Cámara, Raúl González-Bernal, Jerónimo J. González-Santos, Josefa Aguilar-Parra, José M. Trigueros, Rubén López-Liria, Remedios Kjær, Troels Wesenberg Int J Environ Res Public Health Case Report Super-refractory status epilepticus (SRSE) represents a neurological emergency that is characterized by a lack of response to the third line of antiepileptic treatment, including intravenous general anesthetics. It is a medical challenge with high morbidity and mortality. Electroconvulsive therapy (ECT) has been recommended as a nonpharmacologic option of treatment after other alternatives are unsuccessful. Its effect on the cessation of SRSE has been minimally investigated. The objective of this article is to analyze the effect of ECT on SRSE. For this purpose, a multidisciplinary team created a protocol based on clinical guidelines similar to those described previously by Ray et al. (2017). ECT was applied to six patients with SRSE after the failure of antiepileptic treatment and pharmacologic coma.The objective of each ECT session was to elicit a motor seizure for at least 20 s. SRSE was resolved in all patients after several days of treatment, including ECT as a therapy, without relevant adverse effects. Thus, ECT is an effective and feasible option in the treatment of SRSE, and its place in the algorithm in treatment should be studied due to the uncommon adverse effects and the noninvasive character of the therapy. MDPI 2020-06-05 2020-06 /pmc/articles/PMC7312395/ /pubmed/32516983 http://dx.doi.org/10.3390/ijerph17114023 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Case Report
García-López, Beatriz
Gómez-Menéndez, Ana Isabel
Vázquez-Sánchez, Fernando
Pérez-Cabo, Eva
Isidro-Mesas, Francisco
Zabalegui-Pérez, Arturo
Muñoz-Siscart, Ignacio
Lloria-Gil, María Carmen
Soto-Cámara, Raúl
González-Bernal, Jerónimo J.
González-Santos, Josefa
Aguilar-Parra, José M.
Trigueros, Rubén
López-Liria, Remedios
Kjær, Troels Wesenberg
Electroconvulsive Therapy in Super Refractory Status Epilepticus: Case Series with a Defined Protocol
title Electroconvulsive Therapy in Super Refractory Status Epilepticus: Case Series with a Defined Protocol
title_full Electroconvulsive Therapy in Super Refractory Status Epilepticus: Case Series with a Defined Protocol
title_fullStr Electroconvulsive Therapy in Super Refractory Status Epilepticus: Case Series with a Defined Protocol
title_full_unstemmed Electroconvulsive Therapy in Super Refractory Status Epilepticus: Case Series with a Defined Protocol
title_short Electroconvulsive Therapy in Super Refractory Status Epilepticus: Case Series with a Defined Protocol
title_sort electroconvulsive therapy in super refractory status epilepticus: case series with a defined protocol
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7312395/
https://www.ncbi.nlm.nih.gov/pubmed/32516983
http://dx.doi.org/10.3390/ijerph17114023
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