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Pediatric super‐refractory status epilepticus treated with allopregnanolone
Author(s) -
Broomall Eileen,
Natale JoAnne E.,
Grimason Michele,
Goldstein Joshua,
Smith Craig M.,
Chang Celia,
Kanes Stephen,
Rogawski Michael A.,
Wainwright Mark S.
Publication year - 2014
Publication title -
annals of neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 4.764
H-Index - 296
eISSN - 1531-8249
pISSN - 0364-5134
DOI - 10.1002/ana.24295
Subject(s) - allopregnanolone , status epilepticus , neuroactive steroid , refractory (planetary science) , benzodiazepine , gabaa receptor , medicine , epilepsy , anesthesia , neuroscience , pharmacology , psychology , receptor , biology , astrobiology
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 γ‐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