소아 난치성 간질중첩증 환자에서 Topiramate 사용 1예
A Pediatric Case of Topiramate Treatment for Refractory Status Epilepticus
김소연, 김진경, 이준화,
소속 상세정보
김소연 ( Kim So-Yeon )
대구가톨릭대학교 의과대학 소아과학교실
김진경 ( Kim Jin-Kyung )
대구가톨릭대학교 의과대학 소아과학교실
이준화 ( Lee Jun-Hwa )
대구가톨릭대학교 의과대학 소아과학교실
KMID : 0877220040080020171
Abstract
The definition of refractory status epilepticus (RSE) is the state of epilepticus that persists for longer than 60 minutes despite an adequate dose of benzodiazepine and an antiepileptic drug. Topiramate is a broad-spectrum antiepileptic drug used as a monotherapy as well as an adjunctive therapy in the treatment of epilepsy. We encountered a 32-month-old girl with RSE, who showed spastic quadriplegia, hydrocephalus and a previous history of 3 times recurrence of status epilepticus in the presence of global development. Although the girl was treated with lorazepam, phenytoin, phenobarbital and even with midazolam, seizure lasted for more than 60 minutes. Through pentobarbital coma, seizure was controlled clinically on the state of EEG. However, it recurred. Therefore, the patient was treated with an overdose amount of topiramate (10 mg/kg/day) by nasogastric tube without titration as an add-on therapy and then treated with a reduced amount of topiramate (4 mg/kg/day). Finally, the seizure became controlled.
키워드
Refractory status epilepticus;Pentobarbital coma;Topiramate
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