Journal Article

FZJ-2021-05955

http://join2-wiki.gsi.de/foswiki/pub/Main/Artwork/join2_logo100x88.png Isoflurane in (Super-) Refractory Status Epilepticus: A Multicenter Evaluation

Stetefeld, H. R. ; Schaal, A. ; Scheibe, F. ; Nichtweiß, J. ; Lehmann, F. ; Müller, M.Extern* ; Gerner, S. T. ; Huttner, H. B. ; Luger, S. ; Fuhrer, H. ; Bösel, J. ; Schönenberger, S. ; Dimitriadis, K. ; Neumann, B. ; Fuchs, K. ; Fink, G. R.FZJ* ; Malter, M. P. (Corresponding author)

2021
Springer New York, NY

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Please use a persistent id in citations: http://hdl.handle.net/2128/30299  doi:10.1007/s12028-021-01250-z

Abstract: AbstractBackground: We aimed to determine the association between seizure termination and side effects of isoflurane forthe treatment of refractory status epilepticus (RSE) and super-refractory status epilepticus (SRSE) in neurointensivecare units (neuro-ICUs).Methods: This was a multicenter retrospective study of patients with RSE/SRSE treated with isoflurane for statusepilepticus termination admitted to the neuro-ICUs of nine German university centers during 2011–2018.Results: We identified 45 patients who received isoflurane for the treatment of RSE/SRSE. During isoflurane treat-ment, electroencephalograms showed no epileptiform discharges in 33 of 41 (80%) patients, and burst suppressionpattern was achieved in 29 of 41 patients (71%). RSE/SRSE was finally terminated after treatment with isoflurane in 23of 45 patients (51%) for the entire group and in 13 of 45 patients (29%) without additional therapy. Lengths of stay inthe hospital and in the neuro-ICU were significantly extended in cases of ongoing status epilepticus under isofluranetreatment (p = 0.01 for length of stay in the hospital, p = 0.049 for length in the neuro-ICU). During isoflurane treat-ment, side effects were reported in 40 of 45 patients (89%) and mainly included hypotension (n = 40, 89%) and/orinfection (n = 20, 44%). Whether side effects occurred did not affect the outcome at discharge. Of 22 patients withfollow-up magnetic resonance imaging, 2 patients (9%) showed progressive magnetic resonance imaging alterationsthat were considered to be potentially associated with RSE/SRSE itself or with isoflurane therapy.Conclusions: Isoflurane was associated with a good effect in stopping RSE/SRSE. Nevertheless, establishing remis-sion remained difficult. Side effects were common but without effect on the outcome at discharge.Keywords: Status epilepticus, Isoflurane, Epilepsy

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Contributing Institute(s):

1. Kognitive Neurowissenschaften (INM-3)

Research Program(s):

1. 5252 - Brain Dysfunction and Plasticity (POF4-525) (POF4-525)

Appears in the scientific report 2021

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Database coverage:
; ; ; Clarivate Analytics Master Journal List ; Current Contents - Clinical Medicine ; DEAL Springer ; Ebsco Academic Search ; Essential Science Indicators ; IF < 5 ; JCR ; SCOPUS ; Science Citation Index Expanded ; Web of Science Core Collection

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