Neuroprotective effects of deep hypothermia in refractory status epilepticus. 2015

Jerome Niquet, and Michael Gezalian, and Roger Baldwin, and Claude G Wasterlain
Department of Neurology David Geffen School of Medicine at UCLA Los Angeles California; Epilepsy Research Laboratory (151)Veterans Affairs Greater Los Angeles Healthcare System Los Angeles California.

Pharmacoresistance develops quickly during repetitive seizures, and refractory status epilepticus (RSE) remains a therapeutic challenge. The outcome of RSE is poor, with high mortality and morbidity. New treatments are needed. Deep hypothermia (20°C) is used clinically during reconstructive cardiac surgery and neurosurgery, and has proved safe and effective in those indications. We tested the hypothesis that deep hypothermia reduces RSE and its long-term consequences. We used a model of SE induced by lithium and pilocarpine and refractory to midazolam. Several EEG measures were recorded in both hypothermic (n = 17) and normothermic (n = 20) animals. Neuronal injury (by Fluoro-Jade B), cell-mediated inflammation, and breakdown of the blood-brain barrier (BBB) (by immunohistochemistry) were studied 48 h following SE onset. Normothermic rats in RSE seized for 4.1 ± 1.1 h, and at 48 h they displayed extensive neuronal injury in many brain regions, including hippocampus, dentate gyrus, amygdala, entorhinal and pyriform cortices, thalamus, caudate/putamen, and the frontoparietal neocortex. Deep hypothermia (20°C) of 30 min duration terminated RSE within 12 min of initiation of hypothermia, reduced EEG power and seizure activity upon rewarming, and eliminated SE-induced neuronal injury in most animals. Normothermic rats showed widespread breakdown of the BBB, and extensive macrophage infiltration in areas of neuronal injury, which were completely absent in animals treated with hypothermia. These results suggest that deep hypothermia may open a new therapeutic avenue for the treatment of RSE and for the prevention of its long-term consequences.

UI MeSH Term Description Entries

Related Publications

Jerome Niquet, and Michael Gezalian, and Roger Baldwin, and Claude G Wasterlain
January 2008, Neurocritical care,
Jerome Niquet, and Michael Gezalian, and Roger Baldwin, and Claude G Wasterlain
June 2015, Chinese medical journal,
Jerome Niquet, and Michael Gezalian, and Roger Baldwin, and Claude G Wasterlain
September 2013, Epilepsia,
Jerome Niquet, and Michael Gezalian, and Roger Baldwin, and Claude G Wasterlain
July 2015, The Canadian journal of neurological sciences. Le journal canadien des sciences neurologiques,
Jerome Niquet, and Michael Gezalian, and Roger Baldwin, and Claude G Wasterlain
April 2015, Clinical neurology and neurosurgery,
Jerome Niquet, and Michael Gezalian, and Roger Baldwin, and Claude G Wasterlain
April 1984, Critical care medicine,
Jerome Niquet, and Michael Gezalian, and Roger Baldwin, and Claude G Wasterlain
June 2020, Biomedical journal,
Jerome Niquet, and Michael Gezalian, and Roger Baldwin, and Claude G Wasterlain
December 2018, Continuum (Minneapolis, Minn.),
Jerome Niquet, and Michael Gezalian, and Roger Baldwin, and Claude G Wasterlain
March 2012, Brain research,
Jerome Niquet, and Michael Gezalian, and Roger Baldwin, and Claude G Wasterlain
April 2022, Continuum (Minneapolis, Minn.),
Copied contents to your clipboard!