Lee Wai Kin, Liu Kam Tim, Young Betty Wan Yin
Department of Paediatrics and Adolescent Medicine, Pamela Youde Nethersole Eastern Hospital, Hong Kong Special Administrative Region, China.
Pediatr Neurol. 2006 Jan;34(1):63-5. doi: 10.1016/j.pediatrneurol.2005.06.014.
This report describes the management of three children, ranging in age from 7 to 9 years, who had refractory status epilepticus. This condition was likely the result of viral encephalitis; it manifested initially as generalized tonic-clonic seizure and later frequent subtle eye staring and twitching of mouth or limbs as well as tachycardia and dilatation of pupils. The seizures were not responsive to treatment with conventional doses of intravenous phenobarbital, phenytoin, and midazolam infusion. Very-high-dose phenobarbital was administered at accumulated daily doses up to 80 mg/kg, with a resulting serum level of more than 1000 mumol/L. It was effective in achieving seizure control, with milder adverse effects compared with thiopental infusion.
本报告描述了三名年龄在7至9岁之间患有难治性癫痫持续状态儿童的治疗情况。这种情况可能是病毒性脑炎所致；最初表现为全身性强直阵挛发作，随后频繁出现轻微的凝视、口角或肢体抽搐，以及心动过速和瞳孔散大。这些发作对常规剂量的静脉注射苯巴比妥、苯妥英和咪达唑仑输注治疗无反应。给予了极高剂量的苯巴比妥，每日累积剂量高达80mg/kg，血清水平超过1000μmol/L。它在控制癫痫发作方面有效，与硫喷妥钠输注相比不良反应较轻。
