1/6. life-saving epilepsy surgery for status epilepticus caused by cortical dysplasia.A uniquely successful neurosurgical intervention in a four-month-old child suffering from status epilepticus (SE) caused by focal cortical dysplasia is reported. seizures appeared at postnatal day 10 and culminated as medically intractable focal motor SE three months later. The first MRI scan at postnatal week 2 was inconclusive; electroclinical features typical of malformations of cortical development led to the repetition of MRI at the age of 3 months that confirmed the correct diagnosis. Since all medical trials including thiopental anaesthesia have been unsuccessful in treatment of SE, urgent resection of the right frontal and parietal lobes was performed at 4 months of age. One month later, the child had become seizure-free and her psychomotor development is proceeding well. Histopathological analysis of the resected brain tissue revealed abnormalities typical of the Taylor's type of focal cortical dysplasia. The aim of the report is to encourage considering surgery in selected patients suffering from medically intractable SE early in life.- - - - - - - - - - ranking = 1keywords = anaesthesia (Clic here for more details about this article) |
2/6. isoflurane anaesthesia in the treatment of convulsive status epilepticus. Case report.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.- - - - - - - - - - ranking = 5keywords = anaesthesia (Clic here for more details about this article) |
3/6. isoflurane in the management of status epilepticus after surgery for lesion around the motor area.When conventional treatment for status epilepticus fails, general anaesthesia is recommended. We present our experience with isoflurane, an inhalational anaesthetic, in the management of four patients with status epilepticus which occurred soon after surgery for motor area lesion. The seizures were controlled with relatively small concentrations of isoflurane. hypotension, the only adverse effect of isoflurane, was managed easily with the use of dopamine in physiological saline. Although status epilepticus occurring soon after surgery is transient, it carries a risk of persistent brain damage if active treatment is not instituted promptly. isoflurane general anaesthesia may be recommended to control it in the intensive neurosurgical care.- - - - - - - - - - ranking = 2keywords = anaesthesia (Clic here for more details about this article) |
4/6. status epilepticus following enflurane anaesthesia.Two patients had generalised convulsions which occurred several hours after anaesthesia supplemented with enflurane. One patient had to be treated for life threatening status epilepticus 7 hours after anaesthesia and the other had a myoclonic convulsion 17 hours after recovery from anaesthesia. Neither had any relevant pre-operative history of epilepsy or convulsions. Possible synergistic roles of the metabolite of atracurium, laudanosine, as well as of cephazolin and photic stimulation, are discussed.- - - - - - - - - - ranking = 7keywords = anaesthesia (Clic here for more details about this article) |
5/6. Diet induced ketosis in epilepsy and anaesthesia. Metabolic changes in three patients on a ketogenic diet.Ketogenic diets have a high fat and low carbohydrate and low protein content to induce ketosis which is monitored by daily urine testing. Lapses in diet are frequently associated with loss of anticonvulsant control. There has, as yet, been no report of children maintained on a ketogenic diet subject to anaesthesia and surgery: this paper records the changes in metabolic variables observed in three patients undergoing simple inhalation anaesthetics for minor surgery.- - - - - - - - - - ranking = 5keywords = anaesthesia (Clic here for more details about this article) |
6/6. Treatment of status epilepticus with thiopentone sodium anaesthesia in a child.A 4-month-old infant was admitted to the Pediatric intensive care Unit with Pneumococcal meningitis. A few hours after admission he developed intractable convulsions that could not be stopped with phenytoin, phenobarbitone and a continuous drip of diazepam. Thiopentone sodium anaesthesia was induced for 24 h terminating the status epilepticus. The clinical course, correlary EEG findings, treatment protocol and blood levels of the drugs given are described in detail.- - - - - - - - - - ranking = 5keywords = anaesthesia (Clic here for more details about this article) |