Introduction. Status epilepticus is associated with neuronal breakdown. Radiological sequelae of status epilepticus include diffusion\nweighted abnormalities and T2/FLAIR cortical hyperintensities corresponding to the epileptogenic cortex. However, progressive\ngeneralized cerebral atrophy fromstatus epilepticus is underrecognized andmay be related to neuronal death.We present here a case\nof diffuse cerebral atrophy that developed during the course of super refractory status epilepticus management despite prolonged\nbarbiturate coma. Methods. Case report and review of the literature. Case. A 19-year-old male with a prior history of epilepsy\npresented with focal clonic seizures. His seizures were refractory tomultiple anticonvulsants and eventually required pentobarbital\ncoma for 62 days and midazolamcoma for 33 days. Serial brain magnetic resonance imaging (MRI) showed development of cerebral\natrophy at 31 days after admission to our facility and progression of the atrophy at 136 days after admission. Conclusion. This case\nhighlights the development and progression of generalized cerebral atrophy in super refractory status epilepticus. The cerebral\natrophy was noticeable at 31 days after admission at our facility which emphasizes the urgency of definitive treatment in patients\nwho present with super refractory status epilepticus. Further research into direct effects of therapeutic coma is warranted.
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