Response to Hydrocortisone in an Extremely Preterm Neonate With Late-Onset Sepsis, Meningoencephalitis, and Drug-Resistant Seizures.

IF 1.6 4区 医学 Q3 CLINICAL NEUROLOGY Clinical EEG and Neuroscience Pub Date : 2024-03-01 Epub Date: 2022-12-25 DOI:10.1177/15500594221147138
Ralf Eberhard, Katryn Paquette, Jarred Garfinkle, Kenneth A Myers
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Abstract

Corticosteroids are commonly used in children with bacterial meningitis; however, there are very few data regarding possible utility in neonates, particularly those born premature. We describe our experience using hydrocortisone in the treatment of a girl born at 26 weeks, 6 days gestation. She had suffered profound brain injury following late onset group B streptococcus sepsis and meningitis, and developed drug-resistant seizures. Because seizures continued despite treatment with phenobarbital, phenytoin, levetiracetam, lacosamide, and midazolam, intravenous hydrocortisone was added. We observed a marked decrease in focal electrographic seizures within 2 days of initiation of hydrocortisone. This experience suggests that corticosteroids could be a treatment option for drug-resistant seizures and status epilepticus in preterm neonates, particularly those with bacterial meningitis.

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晚期败血症、脑膜脑炎和耐药性癫痫发作的极早产新生儿对氢化可的松的反应
皮质类固醇是细菌性脑膜炎患儿的常用药物,但有关其在新生儿,尤其是早产儿中的应用的数据却很少。我们介绍了使用氢化可的松治疗一名妊娠 26 周零 6 天的女婴的经验。她因晚期 B 组链球菌败血症和脑膜炎而遭受严重脑损伤,并出现耐药性癫痫发作。由于在使用苯巴比妥、苯妥英、左乙拉西坦、拉科萨胺和咪达唑仑等药物治疗后,癫痫仍持续发作,因此需要静脉注射氢化可的松。我们观察到,在开始使用氢化可的松的两天内,局灶性电图癫痫发作明显减少。这一经验表明,皮质类固醇可作为早产新生儿(尤其是患有细菌性脑膜炎的新生儿)耐药性癫痫发作和癫痫状态的一种治疗选择。
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来源期刊
Clinical EEG and Neuroscience
Clinical EEG and Neuroscience 医学-临床神经学
CiteScore
5.20
自引率
5.00%
发文量
66
审稿时长
>12 weeks
期刊介绍: Clinical EEG and Neuroscience conveys clinically relevant research and development in electroencephalography and neuroscience. Original articles on any aspect of clinical neurophysiology or related work in allied fields are invited for publication.
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