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,...

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Autores principales:	Manuela L’Erario, Rosa Maria Roperto, Anna Rosati
Formato:	article
Lenguaje:	EN
Publicado:	Wiley 2021
Materias:	children FIRES NORSE plasma exchange refractory status epilepticus sevoflurane Neurology. Diseases of the nervous system RC346-429
Acceso en línea:	https://doaj.org/article/6637943c79914a3d8d5eb456ffa10d0c
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spelling	oai:doaj.org-article:6637943c79914a3d8d5eb456ffa10d0c2021-12-01T06:09:19ZSevoflurane as bridge therapy for plasma exchange and Anakinra in febrile infection–related epilepsy syndrome2470-923910.1002/epi4.12545https://doaj.org/article/6637943c79914a3d8d5eb456ffa10d0c2021-12-01T00:00:00Zhttps://doi.org/10.1002/epi4.12545https://doaj.org/toc/2470-9239Abstract 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.Manuela L’ErarioRosa Maria RopertoAnna RosatiWileyarticlechildrenFIRESNORSEplasma exchangerefractory status epilepticussevofluraneNeurology. Diseases of the nervous systemRC346-429ENEpilepsia Open, Vol 6, Iss 4, Pp 788-792 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	children FIRES NORSE plasma exchange refractory status epilepticus sevoflurane Neurology. Diseases of the nervous system RC346-429
spellingShingle	children FIRES NORSE plasma exchange refractory status epilepticus sevoflurane Neurology. Diseases of the nervous system RC346-429 Manuela L’Erario Rosa Maria Roperto Anna Rosati Sevoflurane as bridge therapy for plasma exchange and Anakinra in febrile infection–related epilepsy syndrome
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.
format	article
author	Manuela L’Erario Rosa Maria Roperto Anna Rosati
author_facet	Manuela L’Erario Rosa Maria Roperto Anna Rosati
author_sort	Manuela L’Erario
title	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_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_sort	sevoflurane as bridge therapy for plasma exchange and anakinra in febrile infection–related epilepsy syndrome
publisher	Wiley
publishDate	2021
url	https://doaj.org/article/6637943c79914a3d8d5eb456ffa10d0c
work_keys_str_mv	AT manuelalerario sevofluraneasbridgetherapyforplasmaexchangeandanakinrainfebrileinfectionrelatedepilepsysyndrome AT rosamariaroperto sevofluraneasbridgetherapyforplasmaexchangeandanakinrainfebrileinfectionrelatedepilepsysyndrome AT annarosati sevofluraneasbridgetherapyforplasmaexchangeandanakinrainfebrileinfectionrelatedepilepsysyndrome
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Sevoflurane as bridge therapy for plasma exchange and Anakinra in febrile infection–related epilepsy syndrome

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