Shinnar Shlomo
Comprehensive Epilepsy Management Center, Montefiore Medical Center, Albert Einstein College of Medicine, NY 10467, USA.
J Child Neurol. 2007 May;22(5 Suppl):14S-20S. doi: 10.1177/0883073807303065.
This article reviews how long seizures last and how frequently seizures are prolonged, risk factors for prolonged seizures, and a conceptual framework that links them. These data are derived from studies of patients with a first unprovoked seizure, studies of children with febrile seizures, studies of population-based and community-based cohorts with newly diagnosed epilepsy and patients with refractory epilepsy, and treatment trials. Prolonged seizures that exceed 5 to 10 minutes are relatively common, and the key factor in the identification of those at risk is a history of a prior prolonged seizure. A subgroup of patients with seizures is predisposed to prolonged although not necessarily frequent seizures, which are associated with increased morbidity, increased emergency department visits, and a decreased quality of life. This article also addresses criteria used to justify treatment of a seizure once it has continued longer than 5 minutes and the rationale for such treatment.
本文回顾了癫痫发作持续的时长、癫痫发作延长的频率、癫痫发作延长的危险因素以及将它们联系起来的概念框架。这些数据来源于对首次无诱因癫痫发作患者的研究、对热性惊厥儿童的研究、对新诊断癫痫的基于人群和社区队列的研究、对难治性癫痫患者的研究以及治疗试验。超过5至10分钟的癫痫持续状态相对常见，识别高危患者的关键因素是既往有癫痫持续状态病史。有一部分癫痫患者易发生癫痫持续状态，尽管发作不一定频繁，这与发病率增加、急诊就诊次数增加以及生活质量下降有关。本文还讨论了癫痫发作持续超过5分钟后进行治疗的合理标准以及这种治疗的基本原理。
