case_images: PMC11830119_01
case_images: Electroencephalography on day 16. (A) Density-modulated spectral array maps showing high- and low-frequency peaks (in rectangles) every 5 min. (B) Ictal EEG of a high-frequency peak portion (arrow) showing a cluster of apneic seizures during continuous thiopental administration at 4 mg/kg/h. (C) Postictal EEG of a low-frequency peak portion (arrow) during continuous thiopental administration at 8 mg/kg/h.
case_images: cureus-0017-00000077568-i01.jpg
case_images: PMC11830119_01_cureus-0017-00000077568-i01.jpg
case_images: FIG1
case_images: The EEG showed rhythmic waves with frontal dominance approximately every five minutes; the seizures finally resolved after the dose of thiopental was increased to 8 mg/kg/h (Figure 1).
case_images: Brain magnetic resonance imaging on day 11. Diffusion-weighted imaging showing hyperintensity in the bilateral hippocampus (red arrows).
case_images: cureus-0017-00000077568-i02.jpg
case_images: PMC11830119_01_cureus-0017-00000077568-i02.jpg
case_images: FIG2
case_images: Patient disease course. Chart presenting the progress from hospital admission to the start of intensive care management and until extubation.
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case_images: PMC11830119_01_cureus-0017-00000077568-i03.jpg
case_images: FIG3
case_images: On the 34th day, thiopental was tapered and changed to continuous midazolam, and the patient was extubated (Figure 3).
case_images: Electroencephalography on days 20 and 41. (A) On day 20, one day after initiating perampanel at 2 mg/kg/day, sporadic sharp waves seen predominantly in the frontal regions during continuous midazolam administration at 0.2 mg/kg/h. (B) On day 41, no sharp waves visible during perampanel administration at 8 mg/kg/day.
case_images: cureus-0017-00000077568-i04.jpg
case_images: PMC11830119_01_cureus-0017-00000077568-i04.jpg
case_images: FIG4
case_images: Brain magnetic resonance imaging on day 96. Fluid-attenuated inversion recovery (FLAIR) sequence showing bilateral hippocampal atrophy (red arrows).
case_images: cureus-0017-00000077568-i05.jpg
case_images: PMC11830119_01_cureus-0017-00000077568-i05.jpg
case_images: FIG5
case_images: MRI showed bilateral hippocampal atrophy (Figure 5).