Multiple organ dysfunction syndrome with generalized convulsion status: a case report

DOI
  • Hoshiyama Eisei
    Department of Neurology, Dokkyo Medical University Emergency and Critical Care Medical Center, Dokkyo Medical University
  • Takano Masatsugu
    Department of Neurology, Dokkyo Medical University
  • Takekawa Hidehiro
    Department of Neurology, Dokkyo Medical University Department of Stroke Center, Dokkyo Medical University
  • Shishido Hiroyuki
    Emergency and Critical Care Medical Center, Dokkyo Medical University
  • Nagayama Masao
    Department of Neurology, International University of Health and Welfare School of Medicine
  • Ono Kazuyuki
    Emergency and Critical Care Medical Center, Dokkyo Medical University
  • Hirata Koichi
    Department of Neurology, Dokkyo Medical University

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Other Title
  • 全身痙攣重積状態に多臓器不全を呈した1症例

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<p>A 42-year-old male patient was admitted to our hospital because of generalized convulsive status epilepticus (GCSE), disturbance of consciousness, and shock. He had cardiopulmonary arrest after arrival our hospital, but he was return of spontaneous circulation as soon as cardiopulmonary resuscitation. He had disseminated intravascular coagulation (DIC) and multiple organ dysfunction. From the time of admission, we managed about the patient's breathing, circulation, body temperature. We also administrated sodium valproate 400mg, levetiracetam 1,000mg daily, and continuous use of midazolam to status epilepticus. In addition, he underwent continuous renal replacement therapy because of acute renal failure. The electroencephalogram showed scattered delta waves. Brain MR images showed hyper-intense lesions at bilateral pallidum and thalami, which led to a diagnosis of hypoxic encephalopathy associated with long-term GCSE. On day 13, he started tracking our fingers with his eyes. On day 34, he was able to obey commands and he was transferred to the general ward. GCSE is known to exhibit various organ dysfunctions. In this case, there was a history of epilepsy and had developed on GCSE, but as a result of the clinical examination, it was considered epilepsy-related organ dysfunction because the cause of multiple organ dysfunction was not clear.</p>

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