Intensive Intracranial Pressure and Temperature Monitoring May Improve the Outcome of a Young Patient with Severe Cryptogenic New-onset Refractory Status Epilepticus: A Case Report
Abstract
As the name implies, new-onset refractory status epilepticus is a condition wherein a pediatric or a young adult patient with no previous history of epilepsy suddenly develops idiopathic, uninterrupted, and difficult-to-control seizure episodes. While different neurosurgical interventions in new-onset refractory status epilepticus have already been reported, they are primarily used for palliation and diagnostic purposes. Here we report a young comatose patient who significantly improved after being subjected to intensive intracranial pressure management. Our patient was a 20-year-old male construction worker who was transferred to our institution after he was managed for 13 days (X day [day of ictus] to X+12 days) at a local hospital as a case of refractory status epilepticus. Since the patient has non-convulsive status epilepticus induced by minor stimuli, despite continuous midazolam administration, a central venous catheter-based percutaneous thermoregulation system was inserted on the day of the transfer (X+13 days), which depressed the temperature to 37°C, effectively suppressing the electrographic seizure to some extent. Moreover, on X+15 days, an intracranial pressure sensor was implanted, and a ventriculostomy was done to control the increased intracranial pressure induced by uncontrolled seizures. Because the seizure episodes ceased on X+22 days, intracranial pressure monitoring was eventually terminated. Four days later (X+26 days), the patient's wakefulness…
How strong is the evidence?
Evidence Hub reads this as a case report, done in people. Its evidence level is 5 of 5 (Very low · case / narrative / animal / in vitro / in silico). Case reports, narrative reviews, and animal, cell or computer-model studies give the weakest evidence for human health.
Read the paper
Related studies
- Improving sleep quality leads to better mental health: A meta-analysis of randomised controlled trials
- Tocilizumab in patients with severe COVID-19: a retrospective cohort study
- A new aging measure captures morbidity and mortality risk across diverse subpopulations from NHANES IV: A cohort study
- Fruit, vegetable, and legume intake, and cardiovascular disease and deaths in 18 countries (PURE): a prospective cohort study
- Are noise and air pollution related to the incidence of dementia? A cohort study in London, England
- Long COVID symptoms and duration in SARS-CoV-2 positive children — a nationwide cohort study
Go deeper in Evidence Hub
Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.