Electroconvulsive Therapy in Super Refractory Status Epilepticus: Case Series with a Defined Protocol

Beatriz García-López, Ana Isabel Gómez-Menéndez, Fernando Vázquez-Sánchez, Eva Pérez-Cabo, Francisco Isidro-Mesas, Arturo Zabalegui-Pérez, Ignacio Muñoz-Siscart, María Carmen Lloria-Gil, Raúl Soto-Cámara, Jerónimo J. González-Bernal, Josefa González-Santos, José M. Aguilar-Parra, Rubén Trigueros, Remedios López-Liria and Troels Wesenberg Kjær
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Beatriz García-López: Neurophysiology Department, Burgos University Hospital, 09006 Burgos, Spain
Ana Isabel Gómez-Menéndez: Neurophysiology Department, Burgos University Hospital, 09006 Burgos, Spain
Fernando Vázquez-Sánchez: Neurology Department, Burgos University Hospital, 09006 Burgos, Spain
Eva Pérez-Cabo: Intensive Care Unit, Burgos University Hospital, 09006 Burgos, Spain
Francisco Isidro-Mesas: Neurophysiology Department, Burgos University Hospital, 09006 Burgos, Spain
Arturo Zabalegui-Pérez: Intensive Care Unit, Burgos University Hospital, 09006 Burgos, Spain
Ignacio Muñoz-Siscart: Psychiatry Department, Burgos University Hospital, 09006 Burgos, Spain
María Carmen Lloria-Gil: Neurophysiology Department, Burgos University Hospital, 09006 Burgos, Spain
Raúl Soto-Cámara: Department of Health Sciences, University of Burgos, 09001 Burgos, Spain
Jerónimo J. González-Bernal: Department of Health Sciences, University of Burgos, 09001 Burgos, Spain
Josefa González-Santos: Department of Health Sciences, University of Burgos, 09001 Burgos, Spain
José M. Aguilar-Parra: Department of Psychology, Health Research Centre, University of Almeria, 04120 Almeria, Spain
Rubén Trigueros: Department of Psychology, Health Research Centre, University of Almeria, 04120 Almeria, Spain
Remedios López-Liria: Department of Nursing, Physiotherapy and Medicine, Health Research Centre, University of Almería, 04120 Almeria, Spain
Troels Wesenberg Kjær: SjællandsUniversitets Hospital, 4000 Roskilde, Denmark

IJERPH, 2020, vol. 17, issue 11, 1-11

Abstract: Super-refractory status epilepticus (SRSE) represents a neurological emergency that is characterized by a lack of response to the third line of antiepileptic treatment, including intravenous general anesthetics. It is a medical challenge with high morbidity and mortality. Electroconvulsive therapy (ECT) has been recommended as a nonpharmacologic option of treatment after other alternatives are unsuccessful. Its effect on the cessation of SRSE has been minimally investigated. The objective of this article is to analyze the effect of ECT on SRSE. For this purpose, a multidisciplinary team created a protocol based on clinical guidelines similar to those described previously by Ray et al. (2017). ECT was applied to six patients with SRSE after the failure of antiepileptic treatment and pharmacologic coma.The objective of each ECT session was to elicit a motor seizure for at least 20 s. SRSE was resolved in all patients after several days of treatment, including ECT as a therapy, without relevant adverse effects. Thus, ECT is an effective and feasible option in the treatment of SRSE, and its place in the algorithm in treatment should be studied due to the uncommon adverse effects and the noninvasive character of the therapy.

Keywords: electroconvulsive therapy; ECT; super refractory status epilepticus; antiepileptic treatment (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2020
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