[P1-103] Neuropsychiatric Morbities following Treatment for Super-refractory Status Epilepticus in an Adolescent Patient
Convulsive status epilepticus (SE) is a neurologic emergency, and is defined as continuous seizures lasting more than 5 minutes according to the ILAE task force on classification of SE in 2015. Super-refractory status epilepticus (SRSE) continues or recurs 24 hours or more after the administiration of anaesthetic agents, and has a mortality rate up to %50. We present an adolescent patient who was treated for SRSE to discuss the management of morbidities following treatment. The patient had a history of epilepsy treated with monotherapy between the ages of 9-13 years. Family history was positive for seizures in paternal, and pschiatric problems on maternal side. She presented with recurrence of seizures at 16 years during febrile illness. She was administered midazolam infusion following first line treatments for SE. In addition to a combination of multipl antiseizure medications she received thiopental, ketamin and propofol, as well as IVIg, steroids, ketogenic diet, and Mg infusions. Underlying etiology was not clarified despite thorough investigation for infectious, autoimmun and structural etiology. She recovered with full consiciousness and orientation, discharged ambulatory; however developed psychiatric problems including disorganized speech, poverty of ideas, short and long term memory impairment, psychomotor agitation, abnormal sexual behaviours, mood instability, hyperirritability. On the first year follow up she continued to have seizures originating independently from bilateral temporal areas despite polytherapy. She underwent implantation of vagal nerve stimulator with the expectation of decreasing the dose and number of antiseizure medications. Patients who are treated for SRSE may suffer from severe morbidities including pharmacoresistant epilepsy and neuropsychiatric problems.