Microdialysis Findings in a Patient with New Onset Refractory Non-convulsive Status Epilepticus

  
NCJ_cover.jpgBy Helene Hurth, Dennis Schlak, Florian Heinrich Ebner

First Online: 25 September 2019

Introduction
Microdialysis is a well-established tool routinely used in neurocritical units. Metabolic changes in patients with a subarachnoid hemorrhage or traumatic brain injury appear earlier than changes in intracranial pressure (ICP) [1]. Few reports have described metabolic changes, such as elevated interstitial glutamate levels, using microdialysis in humans or animal models of epilepsy [2]. However, little is known about brain metabolism and its time to recovery in humans with status epilepticus.

Case Description
A previously healthy 51-year-old female presented to a primary care hospital with primary onset of a generalized tonic–clonic seizure. A lumbar puncture was performed and showed increased cerebrospinal fluid protein levels but normal glucose and lactate levels. A cerebral magnetic resonance imaging (MRI) scan indicated bilateral temporomesial signal changes in the hippocampus and insula, suggesting encephalitis (Fig. 1). The patient sustained repeated tonic–clonic...

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