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J Epilepsy Res. 2018 Dec 31;8(2):93-96. doi: 10.14581/jer.18016. eCollection 2018 Dec.

Endosulfan-Induced Prolonged Super-Refractory Status Epilepticus.

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1
Department of Neurology, Inje University Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea.

Abstract

Endosulfan is a highly toxic pesticide that causes hyperstimulation of the central nervous system by antagonizing gamma aminobutyric acid-mediated inhibition. Seizure is the most important manifestation of endosulfan poisoning, frequently progressing to status epilepticus and refractory status epilepticus. Here, we report a recent case of a 64-year-old man with endosulfan-induced super-refractory status epilepticus, which persisted for a remarkably longer period than has been described in previous reports. The patient arrived at the emergency room with continuous generalized tonic-clonic seizures. Electroencephalogram-recorded seizures that persisted even after intravenous administration of lorazepam and antiepileptic drugs. Intravenous anesthetic agents were administered for 9 days to confront the persistently recurring seizures. Immediately after this treatment period, the seizures subsided, and the patient showed marked neurological improvement. After 2 months however, he died of multiple systemic complications. This case report elucidates the importance of aggressive evaluation and management including continuous EEG monitoring in cases of endosulfan-related status epilepticus.

KEYWORDS:

Endosulfan poisoning; Endosulfan-induced super-refractory status; Intoxication; Seizure; Status epilepticus

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