The role of dexmedetomidine in post cranioplasty refractory status epilepticus

R Chauhan; N Singh; A Reddy; A Singh

doi:10.1002/anr3.12246

The role of dexmedetomidine in post cranioplasty refractory status epilepticus

Anaesth Rep. 2023 Sep 20;11(2):e12246. doi: 10.1002/anr3.12246. eCollection 2023 Jul-Dec.

Authors

R Chauhan¹, N Singh², A Reddy¹, A Singh³

Affiliations

¹ Department of Anaesthesia and Intensive Care Postgraduate Institute of Medical Education and Research Chandigarh India.
² Department of Anaesthesiology Sanjay Gandhi Postgraduate Institute of Medical Sciences and Research Lucknow India.
³ Department of Neurosurgery Postgraduate Institute of Medical Education and Research Chandigarh India.

PMID: 37736063
PMCID: PMC10511152 (available on 2024-09-20)
DOI: 10.1002/anr3.12246

Abstract

Cranioplasty, specifically a repair of the skull defect resulting from a previous decompressive craniectomy, is a relatively simple procedure associated with a minimal rate of complications. Even though seizures are seen in up to 30% of the patients postoperatively, status epilepticus is not commonly described. Cerebral oedema, ischaemia and neuro-inflammation have been reported as putative causes of seizures in this population. Here, we report a case of refractory status epilepticus unresponsive to standard anti-epileptic and anaesthetic agents. The use of dexmedetomidine helped terminate the episode and led to a favourable outcome. Most of the standard anti-epileptic and anaesthetic agents act through potentiation of GABAergic transmission or sodium channel blockade and postsynaptic adrenoceptor activation by dexmedetomidine may help potentiate their effect. Further studies are needed to investigate its anticonvulsant effect on post-traumatic brain injury and elaborate on optimal dosage.

Keywords: cranioplasty; dexmedetomidine; status epilepticus.

Publication types

Case Reports