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Intensive Care Medicine

, Volume 20, Issue 5, pp 375–378 | Cite as

Fulminant hepatic failure associated with status epilepticus in children: Three cases and a review of potential mechanisms

  • M. K. Decell
  • J. B. Gordon
  • K. Silver
  • K. Meagher-Villemure
Neonatal and Pediatric Intensive Care

Abstract

Fulminant hepatic failure is a rare complication of status epilepticus. Although many of the anticonvulsants used to treat the seizures are known to have hepatotoxic properties, the exact mechanism leading to massive destruction of the liver following a prolonged seizure remains unclear. Three children are presented who developed fulminant hepatic failure following status epilepticus and subsequently died of multiple organ failure. The literature is reviewed with particular attention to the possible interaction between the anticonvulsants and the metabolic consequences of status epilepticus. We postulate that it is a combination of hypoxia and ischemia that occurs during a prolonged seizure with altered metabolism of free radicals secondary to the anticonvulsant drugs which leads to widespread hepatocyte membrane damage.

Key words

Status epilepticus Liver Anticonvulsants 

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Copyright information

© Springer-Verlag 1994

Authors and Affiliations

  • M. K. Decell
    • 1
  • J. B. Gordon
    • 1
  • K. Silver
    • 2
  • K. Meagher-Villemure
    • 3
  1. 1.Division of Pediatric Critical Care, Department of PediatricsThe Montreal Children's Hospital and McGill UniversityMontrealCanada
  2. 2.Division of Pediatric Neurology, Department of PediatricsThe Montreal Children's Hospital and McGill UniversityMontrealCanada
  3. 3.Division of Pediatric Pathology, Department of PediatricsThe Montreal Children's Hospital and McGill UniversityMontrealCanada

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