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新经验:惊厥性癫痫持续状态的经典治疗方法。

New lessons: Classic treatments in convulsive status epilepticus.

作者信息

Renganathan R, Conlon N, Sweeney B

机构信息

Department of Neurology, Cork University Hospital, Cork.

出版信息

Ir Med J. 2007 Nov-Dec;100(10):618-20.

Abstract

Convulsive status epilepticus is a relatively common life-threatening illness requiring prompt intervention. There has been much debate about the appropriate protocol for management of convulsive status epilepticus. Published data on the management of this condition in Ireland is limited. Our aim was to establish if there was a structured, evidence-based or consensus-based protocol being implemented in the management of status epilepticus in our centre. We retrospectively audited all charts with a diagnosis of 'Status Epilepticus' admitted to our hospital from January 1998 to December 2002. A total of 95 episodes of convulsive status epilepticus were recorded. 34 charts were reviewed. Benzodiazepines were the drug class of first choice in 96% of patients. However, the doses of benzodiazepines used varied widely. The most frequent dose of phenytoin used was 1 gram. No one received continuous EEG monitoring during treatment of refractory status epilepticus. Overall mortality was 18%. The results of this study show that there is no consistent protocol was being followed for the management of convulsive status epilepticus in our centre. The drugs of first choice varied between diazepam and lorazepam in most cases. Although phenytoin was used as second line drug, the dose used was frequently suboptimal. We have developed a protocol for the management for convulsive status in our centre.

摘要

惊厥性癫痫持续状态是一种相对常见的危及生命的疾病,需要及时干预。关于惊厥性癫痫持续状态的适当管理方案一直存在很多争议。爱尔兰有关这种疾病管理的已发表数据有限。我们的目的是确定我们中心在癫痫持续状态的管理中是否实施了结构化、基于证据或基于共识的方案。我们回顾性审核了1998年1月至2002年12月期间我院诊断为“癫痫持续状态”的所有病历。共记录了95例惊厥性癫痫持续状态发作。审查了34份病历。苯二氮䓬类药物是96%患者的首选药物类别。然而,所使用的苯二氮䓬类药物剂量差异很大。苯妥英钠最常用的剂量是1克。在难治性癫痫持续状态治疗期间,没有人接受连续脑电图监测。总体死亡率为18%。本研究结果表明,我们中心在惊厥性癫痫持续状态的管理中没有遵循一致的方案。在大多数情况下,首选药物在地西泮和劳拉西泮之间有所不同。虽然苯妥英钠用作二线药物,但其使用剂量往往未达最佳。我们已经制定了我们中心惊厥性癫痫持续状态的管理方案。

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