TY  - JOUR
A1  - Stetefeld, Henning Robert
A1  - Schaal, Alexander
A1  - Scheibe, Franziska
A1  - Nichtweiß, Julia Friederike
A1  - Lehmann, Felix
A1  - Müller, Marcus
A1  - Gerner, Stefan Toni
A1  - Huttner, Hagen Bernhard
A1  - Luger, Sebastian
A1  - Fuhrer, Hannah
A1  - Bösel, Julian
A1  - Schönenberger, Silvia
A1  - Dimitriadis, Konstantinos
A1  - Neumann, Bernhard
A1  - Fuchs, Kornelius
A1  - Fink, Gereon R.
A1  - Malter, Michael Peter
T1  - Isoflurane in (Super-) Refractory Status Epilepticus: A Multicenter Evaluation
T2  - Neurocritical care
N2  - Background: We aimed to determine the association between seizure termination and side effects of isoflurane for the treatment of refractory status epilepticus (RSE) and super-refractory status epilepticus (SRSE) in neurointensive care units (neuro-ICUs).
Methods: This was a multicenter retrospective study of patients with RSE/SRSE treated with isoflurane for status epilepticus termination admitted to the neuro-ICUs of nine German university centers during 2011–2018.
Results: We identified 45 patients who received isoflurane for the treatment of RSE/SRSE. During isoflurane treatment, electroencephalograms showed no epileptiform discharges in 33 of 41 (80%) patients, and burst suppression pattern was achieved in 29 of 41 patients (71%). RSE/SRSE was finally terminated after treatment with isoflurane in 23 of 45 patients (51%) for the entire group and in 13 of 45 patients (29%) without additional therapy. Lengths of stay in the hospital and in the neuro-ICU were significantly extended in cases of ongoing status epilepticus under isoflurane treatment (p = 0.01 for length of stay in the hospital, p = 0.049 for length in the neuro-ICU). During isoflurane treatment, side effects were reported in 40 of 45 patients (89%) and mainly included hypotension (n = 40, 89%) and/or infection (n = 20, 44%). Whether side effects occurred did not affect the outcome at discharge. Of 22 patients with follow-up magnetic resonance imaging, 2 patients (9%) showed progressive magnetic resonance imaging alterations that were considered to be potentially associated with RSE/SRSE itself or with isoflurane therapy.
Conclusions; Isoflurane was associated with a good effect in stopping RSE/SRSE. Nevertheless, establishing remission remained difficult. Side effects were common but without effect on the outcome at discharge.
KW  - Status epilepticus
KW  - Isoflurane
KW  - Epilepsy
Y1  - 2021
UR  - http://publikationen.ub.uni-frankfurt.de/frontdoor/index/index/docId/62811
UR  - https://nbn-resolving.org/urn:nbn:de:hebis:30:3-628115
SN  - 1556-0961
N1  - Open Access funding enabled and organized by Projekt DEAL.
VL  - 35.2021
IS  - 3
SP  - 631
EP  - 639
PB  - Springer
CY  - New York, NY
ER  -