Super-Refractory Status Epilepticus Treated with High Dose Perampanel: Case Series and Review of the Literature

Figure 3

Electroencephalography (EEG): (a) Generalized slowing is seen with lateralized slowing in the left hemisphere. Periodic lateralized epileptiform discharges are seen in the left parieto-occipital region (red box). (b) Frequent seizures without clinical signs were seen arising from the left parieto-occipital region (red box). (c) Immediately before perampanel. At this time, the patient was receiving levetiracetam, lacosamide, valproic acid, and midazolam infusion. (d) 2 hours after perampanel, there is diffuse slowing. No further seizures occurred. Midazolam was stopped. He was eventually weaned off the levetiracetam and lacosamide and discharged on perampanel and valproic acid. Bitemporal montage, sens 7 uV, Lf 1.6 Hz, HF 70 Hz, 15 s epoch.

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