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Starting ketamine for neuroprotection earlier than its current use as an anesthetic/antiepileptic drug late in refractory status epilepticus.
Fujikawa, Denson G.
Afiliación
  • Fujikawa DG; Neurology Department, VA Greater Los Angeles Healthcare System, Sepulveda Ambulatory Care Center and Nursing Home, North Hills, California.
Epilepsia ; 60(3): 373-380, 2019 03.
Article en En | MEDLINE | ID: mdl-30785224
Ketamine is currently being used as an anesthetic/antiepileptic drug in refractory status epilepticus. To validate its use, 2 clinical trials are recruiting patients. However, preclinical studies of its use in chemically induced status epilepticus in rodents have shown that it is remarkably neuroprotective, through N-methyl-d-aspartate-receptor blockade, even when given after the onset of status epilepticus. Human studies have shown that status epilepticus-induced brain damage can be caused by a glutamate analogue and that it occurs in the same brain regions as in the animal studies. We therefore propose that ketamine be started early in the course of human status epilepticus as a neuroprotectant and that it be continued until epileptic discharges are eliminated. Using it as an anesthetic/antiepileptic drug late in the course of refractory status epilepticus only ensures that it is given after widespread brain damage has occurred.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Estado Epiléptico / Fármacos Neuroprotectores / Ketamina / Anestésicos Disociativos / Anticonvulsivantes Límite: Humans Idioma: En Revista: Epilepsia Año: 2019 Tipo del documento: Article Pais de publicación: Estados Unidos

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Estado Epiléptico / Fármacos Neuroprotectores / Ketamina / Anestésicos Disociativos / Anticonvulsivantes Límite: Humans Idioma: En Revista: Epilepsia Año: 2019 Tipo del documento: Article Pais de publicación: Estados Unidos