Bentes Carla C, Pimentel José G
Serviço de Neurologia, Hospital de Santa Maria, Faculdade de Medicina de Lisboa, Lisboa.
Acta Med Port. 2003 Mar-Apr;16(2):77-80.
Convulsive status epilepticus (CSE) is a medical emergency with a prognosis associated to its duration, aetiology and patient age. On account of the absence of a satisfactory definition and of its clinical and electroencephalographical dynamic temporal evolution, recognition of this entity is a major clinical problem. Only the early recognition of CSE allows an urgent treatment, the reason why it should be adopted the following practical definition: 5 min or more of continuous seizures or two or more seizures without regain of consciousness between them. The treatment should be immediately initiated whenever a patient has a convulsion that persists more than 5 min, has a second seizure in the posictal period, or experience a generalized tonic-clonic convulsion at the time of arrival in the emergency department. The typical temporal evolution of CSE affects its prognosis since subtil SE is more refractory to treatment than evident SE. The monitoring of any kind of treatment protocol should have not only a careful clinical observation but also an EEG continuous record.
惊厥性癫痫持续状态（CSE）是一种医疗急症，其预后与发作持续时间、病因及患者年龄相关。由于缺乏令人满意的定义，以及其临床和脑电图动态的时间演变，识别这一病症是一个重大的临床问题。只有早期识别CSE才能进行紧急治疗，因此应采用以下实用定义：持续癫痫发作5分钟或更长时间，或两次或更多次发作且其间未恢复意识。每当患者出现持续超过5分钟的惊厥、在发作后期出现第二次发作或在抵达急诊科时发生全身性强直阵挛性惊厥时，应立即开始治疗。CSE典型的时间演变会影响其预后，因为隐匿性癫痫持续状态比明显的癫痫持续状态更难治疗。对任何治疗方案的监测不仅要有仔细的临床观察，还应有脑电图连续记录。
