Full Text (PDF)
Indian Journal of Emergency Medicine 9(4):p 195-198, October-December 2023. | DOI: 10.21088/ijem.2395.311X.9423.5
Review Article
Refractory Hypoglycemia with Generalized Convulsive Status Epilepticus in Suspected Propranolol Overdose: Is Early Intubation the Key?
Renaldo Pavrey, Nisha Das, Sonal Raj, Mohammad Altamas
Author Information
Licence:
Attribution-Non-commercial 4.0 International (CC BY-NC 4.0)This license enables reusers to distribute, remix, adapt, and build upon the material in any medium or format for noncommercial purposes only, and only so long as attribution is given to the creator.
Indian Journal of Emergency Medicine 9(4):p 195-198, October-December 2023. | DOI: 10.21088/ijem.2395.311X.9423.5
How Cite This Article:
Pavrey R, Das N, Raj S, et al. Refractory Hypoglycemia with Generalized Convulsive Status Epilepticus in Suspected Propranolol Overdose: Is Early Intubation the Key? Indian J Emerg Med. 2023;9(4):195-8.Timeline
Received : April 05, 2023
Accepted : May 31, 2023
Published : June 09, 2023
Abstract
There are many ways to manage status epilepticus. The rationale for aggressive treatment of generalized convulsive status epilepticus lies solely on the premise that best outcomes rely upon rapid seizure control. Metabolic and toxic seizures can be particularly refractory to therapy, exposing a patient to the threat of aspiration, hyperkalemia, rhabdomyolysis, hyperthermia, myocardial infarction, and arrhythmias.The role of intubation is controversial. Neurologists tend to view intubation as a form of “treatment failure”, reflecting inability to treat the seizure with traditional agents.1 However, it is our opinion that intubation is often the key therapeutic intervention to not only control the seizure, but prevent its deadly complications.In our case report, we highlight the emergent airway management of a 29-year-old pre-morbidly healthy female who was referred to us from a secondary care center with generalized convulsive status epilepticus and refractory hypoglycemia, following an alleged history of propranolol overdose.
References
- 1. Farkas J. Pulm Crit – Resuscitationist’s Guide to Status Epilepticus. Pulm Crit.
- 2. Helman A, Koblic P, Reid A, Kovacs G. Emergency Management of Status Epilepticus..
- 3. Beghi E, Carpio A, Forsgren L, et al. Recommendation for a definition of acute symptomatic seizure. Epilepsia. 2010;51:671-5.
- 4. Hesdorffer DC, Benn EK, Cascino GD, et al. Is a first acute symptomatic seizure epilepsy? Mortality and risk for recurrent seizure. Epilepsia. 2009;50:1102-8.
- 5. Cryer PE, Axelrod L, Grossman AB, et al. Evaluation and management of adult hypoglycemic disorders: an Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab. 2009;94:709-28.
- 6. Vue MH, Setter SM. Drug-induced glucose alterations part 1: drug-induced hypoglycemia. Diabetes Spectr. 2011;24(3):171-7.
- 7. Sherwin RS, Saccà L. Effect of epinephrine on glucose metabolism in humans: contribution of the liver. Am J Physiol. 1984;247(2 Pt 1):E157-E165.
- 8. Sharifpour A, Sadeghi M, Zakariae Z, Soleymani M. Seizures and irreversible cardiogenic shock following propranolol poisoning: report of 2 cases and literature review. Clin Med Insights Case Rep. 2022 Sep 23;15:11795476221126981.
- 9. Zaccara G, Giannasi G, Oggioni R, Rosati E, Tramacere L, Palumbo P; convulsive status epilepticus study group of the uslcentro Toscana, Italy. Challenges in the treatment of convulsive status epilepticus. Seizure. 2017 Apr;47:17-24.
Data Sharing Statement
There are no additional data available. All raw data and code are available upon request.
Funding
This research received no funding.
Author Contributions
All authors contributed significantly to the work and approve its publication.
Ethics Declaration
This article does not involve any human or animal subjects.
Acknowledgements
Information not provided.
Conflicts of Interest
The authors report no conflicts of interest in this work.
About this article
Cite this article
Pavrey R, Das N, Raj S, et al. Refractory Hypoglycemia with Generalized Convulsive Status Epilepticus in Suspected Propranolol Overdose: Is Early Intubation the Key? Indian J Emerg Med. 2023;9(4):195-8.
Licence:
Attribution-Non-commercial 4.0 International (CC BY-NC 4.0)This license enables reusers to distribute, remix, adapt, and build upon the material in any medium or format for noncommercial purposes only, and only so long as attribution is given to the creator.
| Received | Accepted | Published |
|---|---|---|
| April 05, 2023 | May 31, 2023 | June 09, 2023 |
DOI: 10.21088/ijem.2395.311X.9423.5
Keywords
IntubationToxic SeizureHypoglycemiaPropranololSearch for Similar Articles
Similar Articles
- Covid 19 Vaccine: Associated Henoch Schonlein Purpura in Young Adult Female
- A Rare Case of Intolerance to Medically Approved Dose of Sildenafil Citrate in a...
- Acute Mesenteric Ischemia: An Unusual Cause of Hematemesis in a 48 Year Old Man
- Brachial Artery Pseudoaneurysm Related Causally to Iatrogenic Coagulopathy in a...
- Combination Therapy for Acute Management of Yellow Oleander Poisoning: A Case Re...
Article Level Metrics
Last UpdatedTuesday 07 July 2026, 11:38:23 (IST)
2530
Accesses
8
890
00
Citations
NA
NA
NA
Download citation
Article Keywords
Keyword Highlighting
Highlight selected keywords in the article text.
Timeline
| Received | April 05, 2023 |
| Accepted | May 31, 2023 |
| Published | June 09, 2023 |
licence
Attribution-Non-commercial 4.0 International (CC BY-NC 4.0)
This license enables reusers to distribute, remix, adapt, and build upon the material in any medium or format for noncommercial purposes only, and only so long as attribution is given to the creator.
