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[神经儿科急症——癫痫发作与急性偏瘫]

[Neuropediatric emergencies--epileptic seizures and acute hemiplegia].

作者信息

Strozzi S, Steinlin M

机构信息

Neuropadätrie, Medizinische Universitats-Kinderklinik, Inselspital, Bern.

出版信息

Ther Umsch. 2005 Aug;62(8):565-70. doi: 10.1024/0040-5930.62.8.565.

Abstract

Status epilepticus and stroke are life-threatening neurological emergencies and immediate recognition and medical management are imperativ. There is a serious risk of neurological sequelae. To limit secondary brain damage a prolonged seizure has to be treated without delay. After a short history and clinical evaluation (principles of resuscitation) a benzodiazepine (usually diazepam or lorazepam) has to be administered and in case of persistence of seizure-activity phenytoin or phenobarbital. Blood- and urine-sample must be collected in the acute phase to perform further metabolic or toxic examinations. A paralysis with acute onset is suspicious for ischaemic or haemorrhagic stroke. A precise neurological examination is mandatory for accurate neuroradiological work-up and to initiate appropriate investigations for risk factors. These patients require an immediate interdisciplinary treatment in a tertiary care centre with neuropaediatry, neuroradiology and neurosurgery.

摘要

癫痫持续状态和中风是危及生命的神经急症,必须立即识别并进行医学处理。存在严重的神经后遗症风险。为限制继发性脑损伤,必须毫不延迟地治疗长时间发作的癫痫。经过简短的病史询问和临床评估(复苏原则)后,必须给予苯二氮䓬类药物(通常是地西泮或劳拉西泮),如果癫痫活动持续,则给予苯妥英钠或苯巴比妥。急性期必须采集血液和尿液样本,以进行进一步的代谢或毒性检查。急性发作的瘫痪怀疑为缺血性或出血性中风。精确的神经系统检查对于准确的神经放射学检查以及启动针对危险因素的适当检查是必不可少的。这些患者需要在拥有神经儿科、神经放射学和神经外科的三级护理中心立即接受多学科治疗。

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