Pediatric Super-Refractory Status Epilepticus Treated with Allopregnanolone

被引：71

作者：

Broomall, Eileen ^{[1
]}

Natale, JoAnne E. ^{[2
]}

Grimason, Michele ^{[1
]}

Goldstein, Joshua ^{[1
]}

Smith, Craig M. ^{[1
]}

Chang, Celia ^{[3
]}

Kanes, Stephen ^{[4
]}

Rogawski, Michael A. ^{[3
]}

Wainwright, Mark S. ^{[1
]}

机构：

[1] Northwestern Univ, Feinberg Sch Med, Ann & Robert H Lurie Childrens Hosp Chicago, Ruth D & Ken M Davee Pediat Neurocrit Care Progra, Chicago, IL 60611 USA

[2] Univ Calif Davis, Dept Pediat, Sch Med, Sacramento, CA 95817 USA

[3] Univ Calif Davis, Dept Neurol, Sch Med, Sacramento, CA 95817 USA

[4] Sage Therapeut, Cambridge, MA USA

来源：

ANNALS OF NEUROLOGY | 2014年 / 76卷 / 06期

关键词：

NEUROACTIVE STEROIDS; GABA(A) RECEPTORS;

D O I：

10.1002/ana.24295

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

摘要：

Super-refractory status epilepticus is a life-threatening condition. Resistance to benzodiazepine and barbiturate treatment for this disorder is thought to be due to internalization of synaptic -aminobutyric acid (GABA)(A) receptors, and withdrawal of benzodiazepines and barbiturates during treatment often triggers seizure recurrence. The neurosteroid allopregnanolone acts as a positive allosteric modulator of synaptic and extrasynaptic GABA(A) receptors. Here we describe the use of allopregnanolone in 2 pediatric patients with super-refractory status epilepticus. This treatment allowed the general anesthetic infusions to be weaned with resolution of status epilepticus. This is the first report of allopregnanolone use to treat status epilepticus in children. Ann Neurol 2014;76:911-915

引用

页码：911 / 915

页数：5

共 16 条

[1] Progress report on new antiepileptic drugs: A summary of the Eleventh Eilat Conference (EILAT XI) [J].

Bialer, Meir ;

Johannessen, Svein I. ;

Levy, Rene H. ;

Perucca, Emilio ;

Tomson, Torbjorn ;

White, H. Steve .

EPILEPSY RESEARCH, 2013, 103 (01) :2-30

[2] Extrasynaptic GABAA Receptors: Their Function in the CNS and Implications for Disease [J].

Brickley, Stephen G. ;

Mody, Istvan .

NEURON, 2012, 73 (01) :23-34

[3] Evaluation of child/adult pharmacokinetic differences from a database derived from the therapeutic drug literature [J].

Ginsberg, G ;

Hattis, D ;

Sonawane, B ;

Russ, A ;

Banati, P ;

Kozlak, M ;

Smolenski, S ;

Goble, R .

TOXICOLOGICAL SCIENCES, 2002, 66 (02) :185-200

[4] Refractory status epilepticus: new insights in presentation, treatment, and outcome [J].

Hocker, Sara ;

Wijdicks, Eelco F. M. ;

Rabinstein, Alejandro A. .

NEUROLOGICAL RESEARCH, 2013, 35 (02) :163-168

[5] Ganaxolone for treating intractable infantile spasms: a multicenter, open-label, add-on trial [J].

Kerrigan, JF ;

Shields, WD ;

Nelson, TY ;

Bluestone, DL ;

Dodson, WE ;

Bourgeois, BFD ;

Pellock, JM ;

Morton, LD ;

Monaghan, EP .

EPILEPSY RESEARCH, 2000, 42 (2-3) :133-139

[6] Neuroactive steroids protect against pilocarpine- and kainic acid-induced limbic seizures and status epilepticus in mice [J].

Kokate, TG ;

Cohen, AL ;

Karp, E ;

Rogawski, MA .

NEUROPHARMACOLOGY, 1996, 35 (08) :1049-1056

[7]

KOKATE TG, 1994, J PHARMACOL EXP THER, V270, P1223

[8] Trafficking of GABAA receptors, loss of inhibition, and a mechanism for pharmacoresistance in status epilepticus [J].

Naylor, DE ;

Liu, HT ;

Wasterlain, CG .

JOURNAL OF NEUROSCIENCE, 2005, 25 (34) :7724-7733

[9]

Reddy D S., 2012, Jasper's Basic Mechanisms of the Epilepsies, P984

[10] Treatment of Status Epilepticus: An International Survey of Experts [J].

Riviello, James J., Jr. ;

Claassen, Jan ;

LaRoche, Suzette M. ;

Sperling, Michael R. ;

Alldredge, Brian ;

Bleck, Thomas P. ;

Glauser, Tracy ;

Shutter, Lori ;

Treiman, David M. ;

Vespa, Paul M. ;

Bell, Rodney ;

Brophy, Gretchen M. .

NEUROCRITICAL CARE, 2013, 18 (02) :193-200

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