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J Pain Palliat Care Pharmacother · Dec 2014
Case ReportsPalliative sedation for status epilepticus in a patient with progressive multifocal leukoencephalopathy.
- Ferdinando Cancelli, Alexandre Dubra, and Gilbert B Zulian.
- J Pain Palliat Care Pharmacother. 2014 Dec 1; 28 (4): 382-3.
AbstractPalliative sedation is defined as the use of sedative drugs in order to reduce the patient's consciousness in case of refractory symptoms. The most used drug is midazolam, a benzodiazepine with a short half-life administered either intravenously or subcutaneously. We discuss on a clinical case requiring an exceptionally high dosage of midazolam-up to 160 mg iv daily-to achieve palliative sedation. The patient was an HIV positive 29-year-old male who was suffering from progressive multifocal leukoencephalopathy complicated by a refractory status epilepticus and who was suspected of previous benzodiazepines and opioid abuse. In such situations of a suffering brain doses of midazolam to achieve symptom control may be much higher than expected.
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