Exogenous Ketone Esters for Refractory Status Epileptics

This study aims to investigate the efficacy of add-on exogenous ketone esters for the treatment of children with refractory generalized convulsive status epilepticus

Inclusion Criteria:Refractory Generalized convulsive status epilepticus.Exclusion Criteria:Failure to obtain informed consent.Recent intake of exogenous ketones, ketogenic diet, or any dietary restrictions/modifications.Hemodynamic or cardio-respiratory instability.Traumatic brain injury.Hypo-/hyperglycemia.Metabolic acidosis.Ketosis (βHB > 2 mmol/L).Associated severe disease condition, including hepatic, renal, respiratory, cardiac, gastrointestinal, endocrinal, and immune systems.Malnutrition/obesity.Limitations to nasogastric tube feeding.Inborn errors of metabolism.Allergies or any other contraindication to exogenous ketone esters.Current or recent (within the last 24 hours) propofol therapy.Intake of carbonic-anhydrase inhibitors.