2019 Volume 26 Issue 1 Pages 19-23
Patient: Thirty-three-year-old female. Medical past history: systemic lupus erythematosus, central hypothyroidism. After emergency transport to the previous doctor due to a disturbance of consciousness (GCS E1V1M1), the patient was intubated and transferred to our hospital. Upon arrival, the patient exhibited systemic tonic convulsions, determined to be status epilepticus (SE), that did not cease upon administration of midazolam and propofol. We attempted to secure a central venous route for further administration of thiopental, but this was difficult owing to the convulsions. We attempted to control the seizures by using inhalational anesthetics. The seizures temporarily ceased after approximately 10 minutes of desflurane administration. A central venous route was secured and we initiated thiopental administration. After a total of two hours of desflurane administration, convulsion cessation was confirmed. Subsequently, intravenous anesthetic administration was tapered and discontinued, and oral anticonvulsant treatment was initiated. Electroencephalography on the 4th hospital day revealed a burst-suppression pattern. We consider the concomitant use of inhalational anesthetics to be useful as a treatment for intractable SE.
