ICNC Abstracts, ICNC 2018

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Oral Ketamine is an Effective and Safe Treatment for Non-Convulsive Status Epilepticus
Archana Murugan

Last modified: 2018-09-15

Abstract


Introduction:Non-convulsive status epilepticus (NCSE) is a complication of established epilepsy, characterized by achange in behavior, cognition, responsiveness, ataxia with or without minimal convulsive seizures . 1NCSE can be difficult to treat and there are no widely-accepted management guidelines. Steroidsand benzodiazepines are commonly used with variable success. We describe our experience withoral ketamine, a N-Methyl D-Aspartate {NMDA} receptor antagonist, to treat four episodes of NCSEin two children.Methodology and Results:Both children were six years old. The first patient had refractory epilepsy with Doose syndrome andhad three separate episodes of NCSE treated with oral ketamine. The second patient hadlissencephaly and refractory epilepsy and presented with increased drowsiness for two weeks. Allepisodes of NCSE were confirmed with EEG criteria prior to treatment. Oral ketamine -1.5mg/kg/day in two divided doses was administered for 3-5 days during each episode. 2   Ketaminedose was weaned over a week during the 2nd and 3rd episodes for  patient one. There was clinicaland EEG improvement in the first patient within three to five days during the first two episodes. EEGwas not performed following the third episode in view of significant clinical improvement. Thesecond patient was noted to be her usual self within three days. No side effects were encountered.Conclusion:We witnessed resolution of NCSE in each episode within 5 days. We recommend considering oralketamine as first or second line therapy for NCSE. Larger studies are needed to confirm this.

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