Enteral Ketamine for Status Epilepticus in Children with Epilepsy.
Publication/Presentation Date
9-1-2024
Abstract
BACKGROUND: Approximately 10% to 20% of children with epilepsy experience status epilepticus (SE), and children with seizure clustering are at higher risk. Ketamine is growing in use for SE. This study examines the efficacy and safety of enteral ketamine in the treatment of convulsive status epilepticus (CSE) characterized by refractory seizure clusters and nonconvulsive status epilepticus (NCSE) in children with epilepsy.
METHODS: Patient charts were reviewed retrospectively. Children with epilepsy aged one to 21 years presenting in SE and treated with enteral ketamine between September 1, 2021 and September 1, 2022 at a pediatric tertiary care center were identified. Resolution or reduction in seizure frequency within 48 hours, clinical presentation, endotracheal intubation, hospitalization duration, side effects, and readmission were assessed.
RESULTS: Nine patients aged two to 21 years were identified. Six patients presented in CSE characterized by recurrent seizures, and three patients presented in NCSE. Five patients had genetic epilepsies, including PCDH19- and MECP2-related epilepsy. Seven patients had resolution or reduction in seizures within 48 hours of ketamine initiation. Two patients were intubated. Hospitalization duration ranged from one to 34 days. Three patients reported side effects. Three patient readmissions with early ketamine treatment had equal or shorter hospitalizations.
CONCLUSIONS: Enteral ketamine may prove an effective, well-tolerated option for treatment of convulsive and nonconvulsive SE in children with epilepsy, including genetic epilepsies, and may prevent intubation and shorten hospitalization time.
Volume
158
First Page
41
Last Page
48
ISSN
1873-5150
Published In/Presented At
DiDomenico, L., Garrity, L. C., Poisson, K. E., & Broomall, E. (2024). Enteral Ketamine for Status Epilepticus in Children with Epilepsy. Pediatric neurology, 158, 41–48. https://doi.org/10.1016/j.pediatrneurol.2024.05.006
Disciplines
Medicine and Health Sciences | Pediatrics
PubMedID
38959648
Department(s)
Department of Pediatrics
Document Type
Article