Midazolam, Ketamine, and Propofol: While We Slept, Others Worked on Anesthetizing Infusions for Refractory Status Epilepticus

Review Clinical Neurology

Ketamine as advanced second-line treatment in benzodiazepine-refractory convulsive status epilepticus in children

Silvia Buratti et al.

Summary: Status epilepticus (SE) is a common neurological emergency in children with no definitive evidence for the treatment of refractory SE. Protocols differ among institutions, but valproate, phenytoin, and levetiracetam are frequently used as second-line treatment. Ketamine, a noncompetitive N-methyl-D-aspartate receptor antagonist, has shown potential as an advanced second-line agent for the treatment of SE. Future research should focus on the role of ketamine as second-line medication in SE pharmacotherapy.

EPILEPSIA (2023)

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Article Clinical Neurology

Management of Refractory Status Epilepticus An International Cohort Study (MORSE CODe) Analysis of Patients Managed in the ICU

Wei-Ting Chiu et al.

Summary: This study retrospectively analyzed the management of refractory status epilepticus with propofol and midazolam in nine medical centers globally, showing comparable efficacy between the two treatments. However, more clinical trials on RSE management are needed. Management approaches including prolonged EEG monitoring may help decrease the duration of anesthetic infusions.

NEUROLOGY (2022)

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Article Clinical Neurology

Ketamine for Management of Neonatal and Pediatric Refractory Status Epilepticus

Marin Jacobwitz et al.

Summary: This retrospective study analyzed the use of ketamine infusion for refractory status epilepticus (RSE) in pediatric patients. The results showed that ketamine was effective in reducing seizure frequency and had few adverse events.

NEUROLOGY (2022)

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Review Clinical Neurology