Sevoflurane as bridge therapy for plasma exchange and Anakinra in febrile infection–related epilepsy syndrome
| Autor: | Manuela L'Erario, Rosa Maria Roperto, Anna Rosati |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Male
Dose NORSE refractory status epilepticus medicine.medical_treatment sevoflurane Sevoflurane Status Epilepticus children medicine Humans Short Research Article RC346-429 Child Adverse effect FIRES Anakinra Plasma Exchange business.industry Short Research Articles Interleukin 1 Receptor Antagonist Protein Febrile infection related epilepsy syndrome Neurology Anesthesia Epilepsy syndromes Etiology Neurology. Diseases of the nervous system Neurology (clinical) business Epileptic Syndromes medicine.drug Ketogenic diet |
| Zdroj: | Epilepsia Open Epilepsia Open, Vol 6, Iss 4, Pp 788-792 (2021) |
| ISSN: | 2470-9239 |
| DOI: | 10.1002/epi4.12545 |
| Popis: | Febrile infection–related epilepsy syndrome (FIRES) is a devastating immune inflammatory–mediated epileptic encephalopathy. Herein, we discuss a previously healthy 8‐year‐old boy with FIRES in whom high dosages of conventional and nonconventional anesthetics were ineffective in treating SE, as were ketogenic diet, intravenous corticosteroids, and immunoglobulins. After 29 days of prolonged SRSE, the patient was successfully treated with sevoflurane paired with plasma exchange, for a total of five days, thus obtaining a stable EEG suppression burst pattern with no adverse events. Anakinra at the dosage of 100 mg b.i.d. was started seven days after sevoflurane and plasma exchange had been discontinued and was effective in ensuring non‐recurrence of SE. Sevoflurane as bridge therapy for immunosuppressive treatment could be considered an early, safe, and effective option in treating convulsive SE in which an autoimmune‐inflammatory etiology can reasonably be hypothesized. |
| Databáze: | OpenAIRE |
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