Dual Antiglutamate Therapy in Super-Refractory Status Epilepticus After Cardiac Arrest: Insights from the SUPER-CAT Study and Current Evidence

Highlights

  • Dual antiglutamate therapy targeting both AMPA and NMDA receptors offers a novel, mechanistically rational approach for managing postanoxic super-refractory status epilepticus (SRSE).
  • The multicenter SUPER-CAT study demonstrated significantly higher rates of SE resolution and reduced 6-month mortality with combined ketamine and perampanel versus other antiseizure treatments in selected post-cardiac arrest patients.
  • Improved awakening rates and trends toward better neurological outcomes underscore the potential for enhanced recovery when unfavorable prognostic indicators are absent.
  • Reversible cholestatic liver injury was more frequent with dual antiglutamate therapy, emphasizing the need for vigilant monitoring during treatment.

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