Calcium-channel blocker verapamil administration in prolonged and refractory status epilepticus

被引:105
作者
Iannetti, P
Spalice, A
Parisi, P
机构
[1] Univ La Sapienza 2, Dept Paediat, Div Child Neurol, Rome, Italy
[2] Univ La Sapienza 2, Dept Paediat, Child Neurol Unit, Rome, Italy
关键词
Status epilepticus; calcium; channel blocker; P-glycoprotein;
D O I
10.1111/j.1528-1167.2005.59204.x
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
We report on an 11-year healthy boy who presented refractory status epilepticus (SE), which was unresponsive to conventional antiepileptic drugs used in the algorithm of the treatment of SE. Based on evidence that verapamil has anticonvulsant activity in animal models and the fact that the boy had a supraventricular tachycardia (140-160 b/min), i.v. verapamil (0.034 mg/min) was administered on day 37, and after a 3.125 mg cumulative verapamil dose (1.5 hour after initiation of the infusion), the patient regained consciousness was able to breathe spontaneously and the electrical SE promptly disappeared. The apparent dramatic response to i.v. verapamil may be explained by its direct anticonvulsant action on the basis of the potential involvement of calcium channels in epileptic activity and that verapamil, a known Pgp inhibitor in the cerebrovascular endothelium in the epilepticus focus, acted by facilitating the brain penetration of the antiepileptic drugs that our patient was receiving simultaneously.
引用
收藏
页码:967 / 969
页数:3
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