Katalin Tóth, Futó Judit
Országos Idegsebészeti Tudományos Intézet, Aneszteziológiai és Intenzív Terápiás Osztály, Budapest.
Orv Hetil. 2002 Jun 2;143(22):1339-46.
Status epilepticus is an emergency situation that can often lead to death or neurocognitive deficits despite adequate therapy is conducted. Etiology and prognosis can be widely heterogeneous. Knowledge of the basic pathophysiologic mechanisms has altered the definition of status epilepticus and the emphasis of therapy has also changed according to that. Today, with neuroprotective approach and recognition of the importance of time-window the management of generalised tonic clonic status became an emergency or critical care task, because intratracheal narcosis is more often and earlier the therapy of choice and even the sufficient treatment can convey serious side effects. In the article, the authors describe the systemic and cerebral pathophysiologic factors during seizure. The authors offer flow-charts illustrating the treatment of patients with generalised tonic clonic status to make the daily work of physicians easier. Early on critical care treatment and multidisciplinary approach is the pledge of reduction in mortality and morbidity.
癫痫持续状态是一种紧急情况,尽管进行了充分治疗,仍常常导致死亡或神经认知缺陷。病因和预后可能差异很大。对基本病理生理机制的认识改变了癫痫持续状态的定义,治疗重点也据此发生了变化。如今,随着神经保护方法的出现以及对时间窗重要性的认识,全身性强直阵挛性癫痫持续状态的管理成为一项急诊或重症护理任务,因为气管内麻醉越来越多地成为首选且更早进行的治疗方法,甚至充分治疗也可能带来严重副作用。在本文中,作者描述了癫痫发作期间的全身和脑部病理生理因素。作者提供了说明全身性强直阵挛性癫痫持续状态患者治疗方法的流程图,以使医生的日常工作更轻松。早期进行重症护理治疗和多学科方法是降低死亡率和发病率的保证。