Status Epilepticus Controlled by Althesin Infusion

Chin, Lincoln; Havill, J. H.; Rothwell, Rebecca

doi:10.1177/0310057x7900700107

Cited by 15 publications

(5 citation statements)

References 8 publications

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“…Concern has been expressed in the literature that Althesin may cause convulsions or may facilitate an epileptic focus (Uppington 1973) in a manner similar to methohexitone (Howells 1968). However, Chin, Havill and Rothwell ( 1979) has reported the use of AIthesin in refractory status epilepticus and we have also reported success in a similar case (Saady, Wong and Hicks 1979).…”

Section: Discussionmentioning

confidence: 55%

Althesin for Neuroanaesthesia

Saady

1979

Anaesth Intensive Care

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Altlzesin was lIsed as an induction agent then diluted and administered as a controlled infusion for 60 patients undergoing 66 procedures. Incremental doses of fentanyl were given to provide additional analgesia. There was delayed awakening in 7 patients (12.1%),3 of whom responded rapidly to narcotic reversal with naloxone. Intracerebral pathology and surgical trauma contributed to the slow recovery in the other 4 patients. Evidence is presented that A lthesin infusions reduce the narcotic requirement. A lthesin anaesthesia provides good neurosurgical conditions without delay in recovery.

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Section: Discussionmentioning

confidence: 55%

Althesin for Neuroanaesthesia

Saady

1979

Anaesth Intensive Care

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“…It is possible that the drug intensifies EEG abnormalities in patients suffering from epilepsy, in common with other anaesthetic agents in subnarcotic doses. For example, Althesin causes appearance of bitemporal abnormalities in EEG tracings of epileptic patients [18] but nevertheless has powerful anticonvulsant activity in experimental epilepsy and in epileptic status [4,5].…”

Section: Discussionmentioning

confidence: 99%

“…Several years ago, Althesin was used successfully in patients suffering from status epilepticus where benzodiazepines, clonazepam and thiopentone had failed [3][4][5]. Unfortunately, this anaesthetic agent is no longer available, but its success suggests that other i.v.…”

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confidence: 99%

Propofol Anticonvulsant Activity in Experimental Epileptic Status

Riu

Petruzzi

Testa³

et al. 1992

British Journal of Anaesthesia

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We have examined the anticonvulsant properties of propofol in high doses in two experimental models of status epilepticus: generalized pentylenetetrazol (PTZ)-induced seizures and partial, cortically applied penicillin G-induced seizures. Propofol was administered either as a single bolus injection or as a bolus injection followed by an infusion for 1 h. When administered as a single bolus injection, propofol 12 mg kg-1 suppressed electrical and clinical seizures in PTZ generalized epileptic status, and an infusion of 50 mg kg-1 h-1 prevented the reappearance of electrical and clinical signs. In focal epileptic status, the single dose stopped paroxysmal activity and the associated clonic jerks for a few seconds. When the bolus dose was followed by an infusion, the firing bursts were replaced by isolated spikes, and contralateral jerks became sporadic and feeble. The greater efficacy of propofol against PTZ convulsions may be a reflection of the opposite action of the two drugs on neural membrane conductance: PTZ induces paroxysmal neural discharge by enhancing membrane conductance while propofol appears to decrease membrane conductance, thus suppressing paroxysmal discharge. There was no close relationship between blood concentration of the anaesthetic and its clinical effects, at least after a short-term infusion, as used in the present experiments. We suggest that propofol may be a potentially useful drug in status epilepticus in patients in whom benzodiazepines, barbiturates and phenytoin have failed.

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“…Alphaxalone has been reported to be a more efficacious agent in treatment of intractable status epilepticus than classic GABAergic agents like barbiturates (Chin et al, 1979). It is also more effective in suppressing epileptic activity in experimental models than thiopental and diazepam (DeRiu et al, 1987).…”

Section: Discussionmentioning

confidence: 99%

Enantioselective Blockade of T-type Ca²⁺ Current in Adult Rat Sensory Neurons by a Steroid That Lacks γ-Aminobutyric Acid-Modulatory Activity

et al. 1998

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A number of steroids seem to have anesthetic effects resulting primarily from their ability to potentiate currents gated by gamma-aminobutyric acidA (GABAA) receptor activation. One such compound is (3alpha,5alpha, 17beta)-3-hydroxyandrostane-17-carbonitrile [(+)-ACN]. We were interested in whether carbonitrile substitution at other ring positions might result in other pharmacological consequences. Here we examine effects of (3beta,5alpha, 17beta)-17-hydroxyestrane-3-carbonitrile [(+)-ECN] on GABAA receptors and Ca2+ channels. In contrast to (+)-ACN, (+)-ECN does not potentiate GABAA-receptor activated currents, nor does it directly gate GABAA-receptor mediated currents. However, both steroids produce an enantioselective reduction of T-type current. (+)-ECN blocked T current with an IC50 value of 0.3 microM with a maximal block of 41%. (+)-ACN produced a partial block of T current (44% maximal block) with an IC50 value of 0.4 microM. Block of T current showed mild use- and voltage-dependence. The (-)-ECN enantiomer was about 33 times less potent than (+)-ECN, with an IC50 value of 10 microM and an amount of maximal block comparable to (+)-ECN. (+)-ECN was less effective at blocking high-voltage-activated Ca2+ current in DRG neurons (IC50 value of 9. 3 microM with maximal block of about 27%) and hippocampal neurons. (+)-ECN (10 microM) had minimal effects on voltage-gated sodium and potassium currents in rat chromaffin cells. The results identify a steroid with no effects on GABAA receptors that produces a partial inhibition of T-type Ca2+ current with reasonably high affinity and selectivity. Further study of steroid actions on T currents may lead to even more selective and potent agents.

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Status Epilepticus Controlled by Althesin Infusion

Abstract: Althesin will control status epilepticus when other agents jail. Its major advantage over other agents is its lack of accumulation because it is readily metabolized. Three patients are reported and relevant literature is discussed.

Cited by 15 publications

References 8 publications

Althesin for Neuroanaesthesia

Althesin for Neuroanaesthesia

Propofol Anticonvulsant Activity in Experimental Epileptic Status

Enantioselective Blockade of T-type Ca²⁺ Current in Adult Rat Sensory Neurons by a Steroid That Lacks γ-Aminobutyric Acid-Modulatory Activity

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Status Epilepticus Controlled by Althesin Infusion

Abstract: Althesin will control status epilepticus when other agents jail. Its major advantage over other agents is its lack of accumulation because it is readily metabolized. Three patients are reported and relevant literature is discussed.

Cited by 15 publications

References 8 publications

Althesin for Neuroanaesthesia

Althesin for Neuroanaesthesia

Propofol Anticonvulsant Activity in Experimental Epileptic Status

Enantioselective Blockade of T-type Ca2+ Current in Adult Rat Sensory Neurons by a Steroid That Lacks γ-Aminobutyric Acid-Modulatory Activity

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Product

Resources

About

Enantioselective Blockade of T-type Ca²⁺ Current in Adult Rat Sensory Neurons by a Steroid That Lacks γ-Aminobutyric Acid-Modulatory Activity