Summary
Status epilepticus may be resistant to intravenous anticonvulsive drugs. In these cases treatment with the inhalation anaesthetic agent isoflurane may be helpful in the further management. We describe a 35-year-old female patient who suffered from status epilepticus with partial seizures. In spite of therapy with benzodiazepine and phenytoin the status evolved into tonic clonic seizures. Treatment with thiopentone sodium did not stop seizure activity. Anaesthesia with isoflurane (dosage up to 1.5 vol.%) carried out twice within 72 h finally led to a termination of status epilepticus. From our own experience and reports in the literature we conclude that general anaesthesia with isoflurane can and should be used in the treatment of severe status epilepticus that does not respond to intravenous anticonvulsive agents.
Similar content being viewed by others
References
Aicardie J, Chevrie JJ (1983) Consequences of status epilepticus in children. In: Delgado-Escueta AV, Wasterlain CG, Treiman DM, Porter RJ (eds) Advances in neurology, vol 34: Status epilepticus. Raven Press, New York, pp 115–125
Burchiel KJ, Stockard JJ, Myers RR, Bickford RG (1975) Epileptogenicity of enflurane and isoflurane. Texas Rep Biol Med 33:562
Brown A, Horton J (1967) Status epilepticus treated by intravenous infusions of thiopentone sodium. BMJ 1:27–28
Clark DL, Hosick EC, Adam N, Castro AD, Rosner BS, Neigh JL (1973) Neural effects of isoflurane (Forane) in man. Anesthesiology 39:261–270
Cucchiara RF, Theye RA, Michenfelder JD (1974) The effects of isoflurane on canine cerebral metabolism and blood flow. Anesthesiology 40:571–574
Delgado-Escueta AV, Wasterlain CG, Treiman DM, Porter RJ (1982) Management of status epilepticus. N Engl J Med 306:1337–1340
Delgado-Escueta AV, Wasterlain CG, Treiman DM, Porter RJ (eds) (1983) Advances in neurology, vol 34: Status epilepticus. Raven Press, New York, p 127
Dworacek B, De Vlieger M (1984) Absence of electroencephalographic excitation pattern under isoflurane anesthesia. Acta Anaesthesiol Belg 3:211–217
Eger EI II, Stevens WC, Cromwell TH (1971) The electroencephalogram in man anesthetized with Forane. Anesthesiology 35:504–508
Ito BM, Sato S, Kufta CV, Tran D (1988) Effect of isoflurane and enflurane on the electrocorticogram of epileptic patients. Neurology 38:924–928
Kavan EM, Julien RM, Lucero JL (1974) Persistent electroencephalographic alteration following administration of some volatile anaesthetics. Br J Anaesth 46:714–721
Kofke AW, Snider MT, Young RSK, Ramer JC (1985) Prolonged low flow isoflurane anesthesia for status epilepticus. Anesthesiology 62:653–656
Meeke RI, Soifer BE, Gelb AW (1989) Isoflurane for the management of status epilepticus. Ann Pharmacother 23:579–581
Newberg LA, Michenfelder JD (1983) Cerebral protection by isoflurane during hypoxemia or ischemia. Anesthesiology 59:29–35
Opitz A, Marschall M, Degen R, Koch D (1983) General anesthesia in patients with epilepsy and status epilepticus. In: Delgado-Escueta AV, Wasterlain CG, Treiman DM, Porter RJ (eds) Advances in neurology, vol 34: Status epilepticus. Raven Press, New York, pp 531–535
Poulton TJ, Ellington RJ (1984) Seizure associated with induction of anesthesia with isoflurane. Anesthesiology 61:471–476
Ropper AH, Kofke WA, Bromfield EB, Kennedy SK (1986) Comparison of isoflurane, halothane, and nitrous oxide in status epilepticus. Ann Neurol 19:98–99
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Hilz, M.J., Bauer, J., Claus, D. et al. Isoflurane anaesthesia in the treatment of convulsive status epilepticus. J Neurol 239, 135–137 (1992). https://doi.org/10.1007/BF00833912
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF00833912