Rinsho Shinkeigaku (Clinical Neurology)

Case Report

A case of febrile infection-related epilepsy syndrome requiring prolonged intensive care management:a trial of intravenous ketamine and intrathecal dexamethasone therapy

Tetsuya Ioku, M.D.1), Takeshi Inoue, M.D.2), Ichiro Kuki, M.D., Ph.D.2), Keisuke Imai, M.D.1), Atsushi Yamamoto, M.D.1) and Masanori Cho, M.D.1)

1) Department of Neurology and Stroke Treatment, Kyoto First Red Cross Hospital
2) Child and Adolescent Epilepsy Center, Department of Pediatric Neurology, Osaka City General Hospital

A 16-year-old male was brought to the emergency room with fever and status epilepticus, and was diagnosed with febrile infection-related epilepsy syndrome (FIRES). Seizure control was not achieved and the patient developed multiple complications. Ketamine infusion therapy and intrathecal dexamethasone therapy were administered, in addition to other anti-seizure treatment and immunotherapy for super-refractory status epilepticus (SRSE). The patient was weaned from the ventilator on day 170 and was able to live at home, although he continued to experience monthly focal motor seizures and moderate motor impairment. This case suggests that more aggressive treatment might be an option in FIRES with prolonged SRSE.
Full Text of this Article in Japanese PDF (2224K)

(CLINICA NEUROL, 62: 123−129, 2022)
key words: febrile infection-related epilepsy syndrome, super-refractory status epilepticus, ketamine, dexamethasone, intrathecal

(Received: 31-Mar-21)