Refractory Status Epilepticus that Responded to Steroid Application

Abstract

The minimum duration of a seizure needed to be described as status epilepticus is a matter ofgreat debate; but many authors use a time period of 5 to 20 minutes. In refractory statusepilepticus, despite treatment with conventional antiepileptic drugs, seizures continue orbaseline values of consciousness between seizures do not return. Status epilepticus due to abrain tumor may be resistant to antiepileptic therapy. A case of refractory status epilepticuscontrolled by steroid application is presented in this report and discussed in the light of literature

Keywords

• Steroid,brain tumour,status epilepticus

Steroid Vermeyi Takiben Düzelen Dirençli Status Epileptikus

Abstract

Status Epileptikus tanısını koyduracak minimum nöbet süresi hakkında tartışmalar bulunmaklabirlikte, çoğu araştırmacı 5-20 dakikalık zaman dilimini kullanmaktadır. Dirençli statusepileptikus ise konvansiyonel antiepileptik ilaç tedavisine rağmen, nöbetlerin devam etmesiveya nöbet aralarında bilincin bazal değerlere dönmediği tablo olarak tanımlanmaktadır. Beyintümörüne bağlı gelişen status epileptikus antiepileptik tedaviye dirençli olabilir. Bu makaledesteroid verilmesiyle kontrol altına alınabilen dirençli bir status epileptikus olgusu sunulmuş veliteratür eşliğinde tartışılmıştır

Keywords

• Steroid,beyin tümörü,status epileptikus

References

1. Haglund MM, Berger MS, Kunkel DDS. Changes in gammaaminobutyric acid and somatostatin in epileptic cortex associated with low grade gliomas. J Neurosurg. 1992;77:209- 216.
2. Glantz MJ, Cole BF, Forsyth PA, Recht LD, Wen PY, Chamberlain MC, Grossman SA. Cairncross JGPractice parameter: anticonvulsant prophylaxis in patients with newly diagnosed brain tumors. Report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology. 2000 ;54:1886-1893.
3. Ünay B, Kalman S, Serdar M, Akın R, Gökçay A. Antiepileptik tedavi alan çocuklarda serum hormon düzeyleri Çocuk Sağlığı ve Hastalıkları Dergisi 2002; 46: 182-186.
4. Schaller B and Rüegg SJ. Brain Tumor and Seizures: Pathophysiology and its implications for treatment revisited. Epilepsia. 2003; 44:1223-1232.
5. Marco P, Sola RG, Ramon Y. Loss of inhibitory synapses on the soma and axon initial segment of pyramidal cells in human epileptic peritumoural neucortex: Implications for epilepsy. Brain Res bull. 1997; 2579-2585.
6. Rick CE, Ye Q, Finn SE, Harrison NL. Neurosteroids act on the GABA(A) receptor at sites on the N-terminal side of the middle of TM2. Neuroreport 1998; 9:379-383.
7. Marik PE, Varon P. The Management of Status Epilepticus, Chest, 2004; 126:582-91.
8. Bleek TP, Refractory status epilepticus in 2001. Arch Neurol 2002; 59:188-189.

9. Smith DF, Hutton JL,, Sandermann D. The prognosis of primary intracerebral tumours presenting with epilepsy: The outcome of medical and surgical management. J Neurol Neurosurg Psychiatry. 1991; 54: 915-920.