Introduction: Convulsive status epilepticus (CSE) refractory to treatm
ent with benzodiazepines, phenobarbital, and phenytoin presents a chal
lenge to pediatric emergency and critical care specialists. Prompt sei
zure control mag prevent mortality and morbidity. Case: A nine-month-o
ld girl with hereditary fructose intolerance had prolonged, refractory
CSE. Her seizures promptly stopped after administration of propofol (
3 mg/kg bolus followed by infusion of 100 mu g/kg/min). This dose resu
lted in electroencephalographic burst suppression, She required endotr
acheal intubation, invasive hemodynamic monitoring, and pressor suppor
t. Discussion: This is the first pediatric case of prolonged, refracto
ry CSE treated wilt propofol. The adult experience is reviewed. Propof
ol should be used only in a setting where definitive airway control an
d hemodynamic support if possible.