Treatment Strategies for the NMDA Component of Organophosphorus Convulsions

Peterson, Steven L.; Griffith, James F.

doi:10.21236/ada418693

Cited by 1 publication

(1 citation statement)

References 20 publications

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“…The rationale for such a combination in anesthesia will not be developed here. Propofol was found devoid of any anticonvulsant properties in soman‐poisoned guinea pigs; unfortunately, details are lacking on the test conditions . This type of combination might offer advantages during hospital treatment of RSE.…”

Section: Ketamine An Effective Treatment Of Seizures: Experimental Ementioning

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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Section: Ketamine An Effective Treatment Of Seizures: Experimental Ementioning

confidence: 99%