naa a22 4500 510799302 CHVBK 20180411083348.0 cr unu---uuuuu 180411e20130801xx s 000 0 eng 10.1007/s12028-013-9858-6 doi (NATIONALLICENCE)springer-10.1007/s12028-013-9858-6 Ketamine for Medically Refractory Status Epilepticus After Elective Aneurysm Clipping [Elektronische Daten] [F. Zeiler, A. Kaufmann, L. Gillman, M. West, J. Silvaggio] Background: Medically refractory status epilepticus, without an identifiable cause, post elective aneurysm clipping is a rare event. Objective: To describe the two cases of refractory status epilepticus post elective aneurysm clipping, without an identifiable cause, and discuss the potential role for early consideration of ketamine. Methods: Retrospectively reviewed two patients at our institution who developed refractory status epilepticus post elective aneurysm clipping, without a defined cause. Results: Two patients who underwent elective aneurysm clipping developed medically refractory status epilepticus post-craniotomy. No structural, vascular, infectious, or metabolic cause was identified. Seizure control failed with multiple medications and intravenous sedatives over the period of weeks in both. Ketamine was instituted at 20 and 40mg/kg/min in these patients. Within hours of starting ketamine, burst suppression was obtained in both. Medications were all tapered over the next month, and both the patients recovered to be cognitively normal, with mild residual morbidity secondary to critical care polyneuropathy. Conclusions: Refractory status epilepticus, in the absence of an identifiable etiology, in elective aneurysm clipping is a rare event. Consideration should be given for the early use of ketamine in refractory status epilepticus. Springer Science+Business Media New York, 2013 Refractory seizure nationallicence Ketamine nationallicence Aneurysm clipping nationallicence Elective clipping nationallicence Status epilepticus nationallicence Zeiler F. Section of Neurosurgery, Department of Surgery, University of Manitoba, Winnipeg, MB, Canada aut Kaufmann A. Section of Neurosurgery, Department of Surgery, University of Manitoba, Winnipeg, MB, Canada aut Gillman L. Section of Critical Care Medicine, Department of Internal Medicine, University of Manitoba, Winnipeg, MB, Canada aut West M. Section of Neurosurgery, Department of Surgery, University of Manitoba, Winnipeg, MB, Canada aut Silvaggio J. Section of Neurosurgery, Department of Surgery, University of Manitoba, Winnipeg, MB, Canada aut Neurocritical Care Springer US; http://www.springer-ny.com 19/1(2013-08-01), 119-124 1541-6933 19:1<119 2013 19 12028 https://doi.org/10.1007/s12028-013-9858-6 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s12028-013-9858-6 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Zeiler F. Section of Neurosurgery, Department of Surgery, University of Manitoba, Winnipeg, MB, Canada aut NATIONALLICENCE 700 1- Kaufmann A. Section of Neurosurgery, Department of Surgery, University of Manitoba, Winnipeg, MB, Canada aut NATIONALLICENCE 700 1- Gillman L. Section of Critical Care Medicine, Department of Internal Medicine, University of Manitoba, Winnipeg, MB, Canada aut NATIONALLICENCE 700 1- West M. Section of Neurosurgery, Department of Surgery, University of Manitoba, Winnipeg, MB, Canada aut NATIONALLICENCE 700 1- Silvaggio J. Section of Neurosurgery, Department of Surgery, University of Manitoba, Winnipeg, MB, Canada aut NATIONALLICENCE 773 0- Neurocritical Care Springer US; http://www.springer-ny.com 19/1(2013-08-01), 119-124 1541-6933 19:1<119 2013 19 12028 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer