Selvitelli Megan, Drislane Frank W
Neurology Department, KS 457, Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Boston, MA 02215, USA.
Curr Neurol Neurosci Rep. 2007 Nov;7(6):529-35. doi: 10.1007/s11910-007-0081-8.
Despite increased understanding of its potential complications, status epilepticus (SE) frequently remains difficult to diagnose and treat. Advances in continuous electroencephalogram (EEG) monitoring facilitate more rapid identification of SE, even without visible clinical signs of seizures. EEG monitoring assists in modifying SE treatment and in making a prognosis. Despite the improved recognition of SE, some patients continue to seize after treatment with intravenous benzodiazepines and other medications. There are new uses for valproic acid, levetiracetam, and topiramate, and they have evidence of efficacy in treating different forms of SE. If medical treatments do not terminate SE, other interventions, such as surgery and stimulation procedures, may promote seizure cessation. This article reviews recent studies evaluating the use of continuous EEG monitoring in the setting of SE, new uses of anticonvulsants, and nonpharmacologic interventions for SE.
尽管对癫痫持续状态（SE）的潜在并发症有了更多了解，但它仍常常难以诊断和治疗。连续脑电图（EEG）监测技术的进步有助于更快速地识别SE，即使没有明显的癫痫发作临床体征。EEG监测有助于调整SE的治疗方案并进行预后判断。尽管对SE的认识有所提高，但仍有一些患者在接受静脉注射苯二氮䓬类药物和其他药物治疗后仍会发作。丙戊酸、左乙拉西坦和托吡酯有了新的用途，并且有证据表明它们在治疗不同形式的SE方面有效。如果药物治疗不能终止SE，其他干预措施，如手术和刺激程序，可能会促进癫痫发作停止。本文综述了近期评估在SE情况下使用连续EEG监测、抗惊厥药的新用途以及SE的非药物干预措施的研究。
