Electroconvulsive therapy for new-onset super-refractory status epilepticus

Chan, Eric Ly; Lee, WC; Koo, CK; King, H.; Woo, CT; Sh, Ng

doi:10.12809/hkmj154501

Cited by 8 publications

(3 citation statements)

References 12 publications

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“…3) was applied to 25 patients. [47][48][49][50][51][52][53][54][55][56][57] The number of ECT sessions and frequency of the treatment varied as seizure control was attempted. Some patients had only one stimulation session on a single day, 52 whereas others received up to six stimulation sessions in one day.…”

Section: Results By the Type Of Neuromodulationmentioning

confidence: 99%

Neuromodulation in Super-refractory Status Epilepticus

Stavropoulos

Pak

Valentin

2021

Journal of Clinical Neurophysiology

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Status epilepticus (SE) is a severe condition that needs immediate pharmacological treatment to tackle brain damage and related side effects. In approximately 20% of cases, the standard treatment for SE does not control seizures, and the condition evolves to refractory SE. If refractory status epilepticus lasts more than 24 hours despite the use of anesthetic treatment, the condition is redefined as super-refractory SE (srSE). sRSE is a destructive condition, potentially to cause severe brain damage. In this review, we discuss the clinical neuromodulation techniques for controlling srSE when conventional treatments have failed: electroconvulsive therapy, vagus nerve stimulation, transcranial magnetic stimulation, and deep brain stimulation. Data show that neuromodulation therapies can abort srSE in .80% of patients.However, no randomized, prospective, and controlled trials have been completed, and data are provided only by retrospective small case series and case reports with obvious inclination to publication bias. There is a need for further investigation into the use of neuromodulation techniques as an early treatment of srSE and to address whether an earlier intervention can prevent longterm complications.

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Section: Results By the Type Of Neuromodulationmentioning

confidence: 99%

Neuromodulation in Super-refractory Status Epilepticus

Stavropoulos

Pak

Valentin

2021

Journal of Clinical Neurophysiology

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“…ECT was performed in 10 patients and was successful in resolving SE in nine of those cases ( 44 , 51 – 54 , 56 ). VNS was implanted in seven patients and was successful in resolving SE in five of those cases ( 43 , 46 – 49 , 55 , 57 ).…”

Section: Resultsmentioning

confidence: 99%

“…Both the mean and median number of drugs (including immune therapies and ketogenic diet) used in every patient was 14. Fourteen patients received immune therapies but only five patients received second-line immune therapies [three had anakinra ( 43 , 49 ) and two had rituximab ( 50 , 51 )]. Figure 4 shows a complete list of other medications and treatments that were used, as well as the percentage of patients administered each, across the 15 studies included in this review.…”

Section: Resultsmentioning

confidence: 99%

Neuromodulation in new-onset refractory status epilepticus

2023

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BackgroundNew-onset refractory status epilepticus (NORSE) and its subset of febrile infection-related epilepsy syndrome (FIRES) are devastating clinical presentations with high rates of mortality and morbidity. The recently published consensus on the treatment of these conditions includes anesthetics, antiseizure drugs, antivirals, antibiotics, and immune therapies. Despite the internationally accepted treatment, the outcome remains poor for a significant percentage of patients.MethodsWe conducted a systematic review of the use of neuromodulation techniques in the treatment of the acute phase of NORSE/FIRES using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.ResultsOur search strategy brought up 74 articles of which 15 met our inclusion criteria. A total of 20 patients were treated with neuromodulation. Thirteen cases represented FIRES and in 17 cases the NORSE remained cryptogenic. Ten had electroconvulsive therapy (ECT), seven had vagal nerve stimulation (VNS), and four had deep brain stimulation (DBS); one patient had initially VNS and later DBS. Eight patients were female and nine were children. In 17 out of 20 patients, the status epilepticus was resolved after neuromodulation, while three patients died.ConclusionNORSE can have a catastrophic course and the first treatment goal should be the fastest possible termination of status epilepticus. The data presented are limited by the small number of published cases and the variability of neuromodulation protocols used. However, they show some potential clinical benefits of early neuromodulation therapy, suggesting that these techniques could be considered within the course of FIRES/NORSE.

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Antiepileptic drugs/anaesthetics

2018

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Electroconvulsive therapy for new-onset super-refractory status epilepticus

Cited by 8 publications

References 12 publications

Neuromodulation in Super-refractory Status Epilepticus

Neuromodulation in Super-refractory Status Epilepticus

Neuromodulation in new-onset refractory status epilepticus

Antiepileptic drugs/anaesthetics

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