Role of NMDA receptors in the pathophysiology and treatment of status epilepticus

Abstract

This review considers the role of N-methyl-d-aspartate receptors in the pathophysiology and treatment of status epilepticus (SE). NMDA receptors play a critical role in sustaining SE by mediating the plasticity of γ-aminobutyric acid (GABA)-A and α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid (AMPA) receptors, neuronal loss, and epileptogenesis. In parallel, there is growing interest in using the NMDA receptor antagonist ketamine in the treatment of refractory SE. Ketamine has proved to be safe for use in refractory and super-refractory SE in patients. The pilot studies also suggest that ketamine may be efficacious for termination of refractory SE.