Mk. Decell et al., FULMINANT HEPATIC-FAILURE ASSOCIATED WITH STATUS EPILEPTICUS IN CHILDREN - 3 CASES AND A REVIEW OF POTENTIAL MECHANISMS, Intensive care medicine, 20(5), 1994, pp. 375-378
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 m
assive 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 t
o the possible interaction between the anticonvulsants and the metabol
ic consequences of status epilepticus. We postulate that it is a combi
nation of hypoxia and ischemia that occurs during a prolonged seizure
with altered metabolism of free radicals secondary to the anticonvulsa
nt drugs which leads to widespread hepatocyte membrane damage.