A Case of Status Epilepticus Successfully Treated with Propofol

Abstract

We report a case of a 35-year-old woman who was admitted to our institution in status epilepticus. She had been epileptic for 34 years, suffering from episodes of both focal and generalized convulsion. On admission she was having facial motor seizures which secondarily developed to tonic-clonic convulsions of the right arm and leg every 2 minutes. She had already been treated with intravenous phenytoin 750mg and acetazolamide 500mg. At this point she was treated with intravenous propofol 200mg and midazolam 10mg, which completely suppressed the seizures. And then, she was intubated and ventilated with intravenous midazolam infusion. Her right side tonic-clonic convulsions were aborted, but her facial motor seizures continued over the next two days. So, we administered propofol infusion, which completely suppressed the remaining seizures. Seventeen days after the first successful treatment, she again developed status epilepticus. Treatment with intravenous propofol alone quickly ceased the second episode of status epilepticus. The second episode of status epilepticus was treated completely with propofol alone. This case report suggests that propofol may be useful for treatment of refractory status epilepticus which is uncontrolled by intravenous phenytoin and midazolam.