Sevoflurane as bridge therapy for plasma exchange and Anakinra in febrile infection–related epilepsy syndrome
Abstract Febrile infection–related epilepsy syndrome (FIRES) is a devastating immune inflammatory–mediated epileptic encephalopathy. Herein, we discuss a previously healthy 8‐year‐old boy with FIRES in whom high dosages of conventional and nonconventional anesthetics were ineffective in treating SE,...
| Main Authors: | , , |
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| Format: | Article |
| Language: | English |
| Published: |
Wiley
2021-12-01
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| Series: | Epilepsia Open |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/epi4.12545 |
| _version_ | 1819021085949034496 |
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| author | Manuela L’Erario Rosa Maria Roperto Anna Rosati |
| author_facet | Manuela L’Erario Rosa Maria Roperto Anna Rosati |
| author_sort | Manuela L’Erario |
| collection | DOAJ |
| description | Abstract Febrile infection–related epilepsy syndrome (FIRES) is a devastating immune inflammatory–mediated epileptic encephalopathy. Herein, we discuss a previously healthy 8‐year‐old boy with FIRES in whom high dosages of conventional and nonconventional anesthetics were ineffective in treating SE, as were ketogenic diet, intravenous corticosteroids, and immunoglobulins. After 29 days of prolonged SRSE, the patient was successfully treated with sevoflurane paired with plasma exchange, for a total of five days, thus obtaining a stable EEG suppression burst pattern with no adverse events. Anakinra at the dosage of 100 mg b.i.d. was started seven days after sevoflurane and plasma exchange had been discontinued and was effective in ensuring non‐recurrence of SE. Sevoflurane as bridge therapy for immunosuppressive treatment could be considered an early, safe, and effective option in treating convulsive SE in which an autoimmune‐inflammatory etiology can reasonably be hypothesized. |
| first_indexed | 2024-12-21T04:01:30Z |
| format | Article |
| id | doaj.art-6637943c79914a3d8d5eb456ffa10d0c |
| institution | Directory Open Access Journal |
| issn | 2470-9239 |
| language | English |
| last_indexed | 2024-12-21T04:01:30Z |
| publishDate | 2021-12-01 |
| publisher | Wiley |
| record_format | Article |
| series | Epilepsia Open |
| spelling | doaj.art-6637943c79914a3d8d5eb456ffa10d0c2022-12-21T19:16:42ZengWileyEpilepsia Open2470-92392021-12-016478879210.1002/epi4.12545Sevoflurane as bridge therapy for plasma exchange and Anakinra in febrile infection–related epilepsy syndromeManuela L’Erario0Rosa Maria Roperto1Anna Rosati2Intensive Care Unit Meyer Children’s Hospital Florence ItalyNephrology Department Meyer Children’s Hospital University of Florence Florence ItalyPaediatric Neurology Unit Meyer Children’s Hospital University of Florence Florence ItalyAbstract Febrile infection–related epilepsy syndrome (FIRES) is a devastating immune inflammatory–mediated epileptic encephalopathy. Herein, we discuss a previously healthy 8‐year‐old boy with FIRES in whom high dosages of conventional and nonconventional anesthetics were ineffective in treating SE, as were ketogenic diet, intravenous corticosteroids, and immunoglobulins. After 29 days of prolonged SRSE, the patient was successfully treated with sevoflurane paired with plasma exchange, for a total of five days, thus obtaining a stable EEG suppression burst pattern with no adverse events. Anakinra at the dosage of 100 mg b.i.d. was started seven days after sevoflurane and plasma exchange had been discontinued and was effective in ensuring non‐recurrence of SE. Sevoflurane as bridge therapy for immunosuppressive treatment could be considered an early, safe, and effective option in treating convulsive SE in which an autoimmune‐inflammatory etiology can reasonably be hypothesized.https://doi.org/10.1002/epi4.12545childrenFIRESNORSEplasma exchangerefractory status epilepticussevoflurane |
| spellingShingle | Manuela L’Erario Rosa Maria Roperto Anna Rosati Sevoflurane as bridge therapy for plasma exchange and Anakinra in febrile infection–related epilepsy syndrome Epilepsia Open children FIRES NORSE plasma exchange refractory status epilepticus sevoflurane |
| title | Sevoflurane as bridge therapy for plasma exchange and Anakinra in febrile infection–related epilepsy syndrome |
| title_full | Sevoflurane as bridge therapy for plasma exchange and Anakinra in febrile infection–related epilepsy syndrome |
| title_fullStr | Sevoflurane as bridge therapy for plasma exchange and Anakinra in febrile infection–related epilepsy syndrome |
| title_full_unstemmed | Sevoflurane as bridge therapy for plasma exchange and Anakinra in febrile infection–related epilepsy syndrome |
| title_short | Sevoflurane as bridge therapy for plasma exchange and Anakinra in febrile infection–related epilepsy syndrome |
| title_sort | sevoflurane as bridge therapy for plasma exchange and anakinra in febrile infection related epilepsy syndrome |
| topic | children FIRES NORSE plasma exchange refractory status epilepticus sevoflurane |
| url | https://doi.org/10.1002/epi4.12545 |
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