Actually we have a patient of 2 y with RSE trated with midazolam propofol and thiopental
as rescue we use ketamine with good results ....
Dear Raul,
unfortunately I have no experience with Ketamine in status epilepticus in children, but I recommend a nice prospective study that provides Class IV evidence of i.v. Ketamine in refractory status epilepticus in children from Rosati et al. (Neurology 2012 Dec 11;79(24):2355-8). They used two i.e. boluses of 2–3 mg/kg each of Ketamine administered 5 minutes apart, immediately followed by continuous infusion of 10 μg/kg/min. Based on clinical or EEG responses, the dose was increased every 10 minutes or longer, using 2–10 μg/kg/min increments, up to 60 μg/kg/min. Add-on midazolam was administered to prevent emergence reactions. The use of Ketamine was associated with resolution of refractory status epilepticus in 6 children. There were no serious adverse events. Among the 3 individuals who did not respond to Ketamine, 2 were cured by surgical removal of epileptogenic focal cortical dysplasia.
Dear Raoul. ....
Thanks for your answer. We obtained a resolution of the RSE and we use the dose recomendad by Rosati
Actually the children is under ketogenic diet .
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