Ketamine and Epilepsy

Corssen, Guenter; Little, Samuel C.; Tavakoli, Mehrdad

doi:10.1213/00000539-197403000-00041

Cited by 51 publications

(11 citation statements)

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“… 57 Ketamine must be used with caution in patients with seizure disorders, since it may decrease the seizure threshold. 58 Moreover, ketamine increases cerebral blood flow, which may intensify intracranial and intraocular pressures. 59 Undesirable recovery reactions, including atrial fibrillation and agitation, have been well documented in the adult literature.…”

Section: Discussionmentioning

confidence: 99%

Is ketamine a lifesaving agent in childhood acute severe asthma?

Hendaus

Jomha

Alhammadi

2016

TCRM

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Children with acute severe asthma exacerbation are at risk of developing respiratory failure. Moreover, conventional aggressive management might be futile in acute severe asthma requiring intubation and invasive ventilation. The aim of this review is to detail evidence on the use of ketamine in childhood asthma exacerbations. A search of the MEDLINE, EMBASE, and Cochrane databases was performed, using different combinations of the following terms: ketamine, asthma, use, exacerbation, and childhood. In addition, we searched the references of the identified articles for additional articles. We then reviewed titles and included studies that were relevant to the topic of interest. Finally, the search was limited to studies published in English and Spanish from 1918 to June 2015. Due to the scarcity in the literature, we included all published articles. The literature reports conflicting results of ketamine use for acute severe asthma in children. Taking into consideration the relatively good safety profile of the drug, ketamine might be a reasonable option in the management of acute severe asthma in children who fail to respond to standard therapy. Furthermore, pediatricians and pediatric emergency clinicians administering ketamine should be knowledgeable about the unique actions of this drug and its potential side effects.

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Section: Discussionmentioning

confidence: 99%

Is ketamine a lifesaving agent in childhood acute severe asthma?

Hendaus

Jomha

Alhammadi

2016

TCRM

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“…The experiments by Kayama and Iwama [10] using cat models revealed that ketamine could induce epileptic changes, based on EEG recordings. However, a similar study of human volunteers conducted by Corssen et al [11] rejected this conclusion. These authors found that ketamine did not cause epileptiform discharges in epilepsy patients or in normal subjects and that no evidence was available to support the notion that ketamine could induce or exacerbate convulsions, in contrast with the conclusions of Kayama [12,13].…”

Section: Introductionmentioning

confidence: 93%

Ketamine for the treatment of refractory status epilepticus

Fang

Wang

2015

Seizure

120

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Status epilepticus (SE) is an acute and severe illness of the central nervous system, and prolonged SE can lead to brain damage and even death. Ketamine is a noncompetitive antagonist of glutamatergic N-methyl-d-aspartate (NMDA) receptors. During prolonged seizures, the numbers and activities of GABA receptors gradually decrease; thus, the commonly used first-line and second-line antiepileptic drugs gradually fail. Simultaneously, the numbers and activities of glutamatergic NMDA receptors increase, often causing refractory status epilepticus (RSE) and thus providing the possibility of the use of ketamine to treat RSE. To improve the prognosis of SE, we present a narrative review of ketamine for the treatment of RSE in the extant literature. We draw the conclusion that ketamine appears to be effective and relatively safe for the control of multidrug-resistant RSE in children and adults.

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“…Some experimental data and subsequent clinical observations reached similar conclusions. However, the first clinical observations have not always been confirmed , and a wealth of experimental evidence favors an antiepileptic action (Table ). It is still considered to potentially be able to facilitate seizures at low doses, not at doses that will produce sedation or anesthesia .…”

Section: Ketamine An Effective Treatment Of Seizures: Clinical Evidencementioning

confidence: 99%

Treatment of Status Epilepticus with Ketamine, Are we There yet?

et al. 2013

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Status epilepticus (SE), a neurological emergency both in adults and in children, could lead to brain damage and even death if untreated. Generalized convulsive SE (GCSE) is the most common and severe form, an example of which is that induced by organophosphorus nerve agents. First- and second-line pharmacotherapies are relatively consensual, but if seizures are still not controlled, there is currently no definitive data to guide the optimal choice of therapy. The medical community seems largely reluctant to use ketamine, a noncompetitive antagonist of the N-methyl-d-aspartate glutamate receptor. However, a review of the literature clearly shows that ketamine possesses, in preclinical studies, antiepileptic properties and provides neuroprotection. Clinical evidences are scarcer and more difficult to analyze, owing to a use in situations of polytherapy. In absence of existing or planned randomized clinical trials, the medical community should make up its mind from well-conducted preclinical studies performed on appropriate models. Although potentially active, ketamine has no real place for the treatment of isolated seizures, better accepted drugs being used. Its best usage should be during GCSE, but not waiting for SE to become totally refractory. Concerns about possible developmental neurotoxicity might limit its pediatric use for refractory SE.

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Ketamine and Epilepsy

Cited by 51 publications

References 0 publications

Is ketamine a lifesaving agent in childhood acute severe asthma?

Is ketamine a lifesaving agent in childhood acute severe asthma?

Ketamine for the treatment of refractory status epilepticus

Treatment of Status Epilepticus with Ketamine, Are we There yet?

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