Thiopentone Induced Paralytic Ileus in Super Refractory Status Epilepticus: Erythromycin to the Rescue

Abstract

Neurocritical care, a unique specialty requiring skill and adeptness presents us with many challenging situations. Management of super refractory status epilepticus warrants the use of intravenous anaesthetic agents and along with it comes its various complications such as paralytic ileus which need to be diagnosed accurately and managed appropriately. We report a case of a patient diagnosed with super refractory status epilepticus who developed paralytic ileus because of thiopentone infusion which was refractory to the conventional prokinetic therapy resulting in the decision to initiate Total Parenteral Nutrition (TPN) but responded dramatically to intravenous erythromycin. Hence, we would like to highlight this as an important tool in the armamentarium in paralytic ileus management.

Keywords

• complex partial seizures
• macrolide
• prokinetic