Ketamine beneficial for treating neonatal, and pediatric epilepsy: study

Epilepsy is a brain condition that causes a child to have seizures. It is one of the most common disorders of the nervous system. It affects children and adults of all races and ethnicities. The brain is made up of nerve cells that communicate with each other through electrical activity.

Few data are available on the use of anaesthetic infusions for refractory status epilepticus (RSE) in children and neonates, and the use of ketamine is increasing despite limited data. The researchers aimed to describe the effect of ketamine on refractory status epilepticus in children and neonates.

A retrospective single-centre cohort study of consecutive patients admitted to the intensive care units of a quaternary care pediatric hospital treated with ketamine infusion for refractory status epilepticus.

Results:

• Sixty-nine patients were treated with ketamine infusion for RSE.

• The median age at onset of refractory status epilepticus was 0.7 years and the cohort included 13 (19%) newborns.

• Three patients (4%) experienced adverse events requiring intervention during or within twelve hours of ketamine administration, including hypertension in 2 patients and delirium in 1 patient.

• Seizure termination in 32 (46%) patients, seizure reduction in 19 (28%) patients, and no change in 18 (26%) patients with ketamine infusion.

Thus, the researchers concluded that ketamine administration is associated with few adverse effects and that seizures often cease or resolve after ketamine administration. More data are needed comparing first-line and subsequent anesthetic drugs for the treatment of pediatric and neonatal resistant status epilepticus. This study provides Class IV evidence of the therapeutic benefit of ketamine for the treatment of refractory status epilepticus in children and neonates.

Reference:

Ketamine for Management of Neonatal and Pediatric Refractory Status Epilepticus

Marin Jacobwitz, Caitlyn Mulvihill, Michael C. Kaufman, Alexander K. Gonzalez, Karla Resendiz, Jennifer M. MacDonald, Conall Francoeur, Ingo Helbig, Alexis A. Topjian, Nicholas S. Abend

Neurology Jul 2022, 10.1212/WNL.0000000000200889; DOI: 10.1212/WNL.0000000000200889

Keywords:

Ketamine, Management, Neonatal, Pediatric, Refractory, Status, Epilepticus, Marin Jacobwitz, Caitlyn Mulvihill, Michael C. Kaufman, Alexander K. Gonzalez, Karla Resendiz, Jennifer M. MacDonald, Conall Francoeur, Ingo Helbig, Alexis A. Topjian, Nicholas S. Abend, Neurology