Treatment of convulsive status epilepticus with propofol: Case report

Introduction: Convulsive status epilepticus (CSE) refractory to treatment with benzodiazepines, phenobarbital, and phenytoin presents a challenge to pediatric emergency and critical care specialists. Prompt seizure control mag prevent mortality and morbidity. Case: A nine-month-old girl with hereditary fructose intolerance had prolonged, refractory CSE. Her seizures promptly stopped after administration of propofol (3 mg/kg bolus followed by infusion of 100 mu g/kg/min). This dose resulted in electroencephalographic burst suppression, She required endotracheal intubation, invasive hemodynamic monitoring, and pressor support. Discussion: This is the first pediatric case of prolonged, refractory CSE treated wilt propofol. The adult experience is reviewed. Propofol should be used only in a setting where definitive airway control and hemodynamic support if possible.