Drug-induced EEG pattern predicts effectiveness of ketamine in treating refractory status epilepticus

Epilepsia. 2015 Apr;56(4):e44-8. doi: 10.1111/epi.12947. Epub 2015 Mar 11.

Abstract

Refractory status epilepticus (RSE) can lack overt clinical manifestation and is usually treated with continuous infusion of intravenous anesthetic drugs (IVADs), where the use of continuous electroencephalography (cEEG) is imperative. Ketamine has recently been shown to be effective in the treatment of RSE. We retrospectively review a cohort of 11 patients receiving ketamine as part of their treatment regimen for RSE. We report on the presence of a characteristic EEG rhythm consisting of a generalized archiform theta to beta rhythms (7-20 Hz) appearing after ketamine administration. This pattern was seen in five patients, four of whom achieved successful resolution of RSE. Ketamine-induced EEG pattern may serve as a biomarker predictive of successful treatment outcome in RSE.

Keywords: Continuous EEG; Intravenous anesthetic drugs; Status epilepticus treatment.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Anesthetics, Dissociative / pharmacology
  • Anesthetics, Dissociative / therapeutic use
  • Anticonvulsants / pharmacology
  • Anticonvulsants / therapeutic use
  • Cohort Studies
  • Electroencephalography / drug effects*
  • Electroencephalography / methods
  • Female
  • Humans
  • Ketamine / pharmacology
  • Ketamine / therapeutic use*
  • Male
  • Middle Aged
  • Predictive Value of Tests
  • Retrospective Studies
  • Status Epilepticus / diagnosis
  • Status Epilepticus / drug therapy*
  • Status Epilepticus / physiopathology*
  • Treatment Outcome

Substances

  • Anesthetics, Dissociative
  • Anticonvulsants
  • Ketamine