Bleck Thomas P
Department of Neurology, Evanston Northwestern Healthcare, Illinois, USA.
Epilepsia. 2007;48 Suppl 8:59-60. doi: 10.1111/j.1528-1167.2007.01352.x.
The intensive care unit management of status epilepticus focuses on patients who are refractory to initial treatment, who have an underlying condition that require critical care management, or who experience respiratory or cardiovascular complications of their therapies. The available data suggest that failure of a first-line anticonvulsant agent to terminate status should lead to the use of a definitive therapy in general anesthetic doses. Midazolam, propofol, and phenobarbital have been used most frequently; the place of newer agents (e.g., valproate, levetiracetam, or topiramate) remains to be determined.
癫痫持续状态的重症监护病房管理主要针对那些对初始治疗无效、存在需要重症监护管理的基础疾病或在治疗过程中出现呼吸或心血管并发症的患者。现有数据表明，一线抗惊厥药物未能终止癫痫持续状态时，一般应使用大剂量麻醉药物进行确定性治疗。咪达唑仑、丙泊酚和苯巴比妥使用最为频繁；新型药物（如丙戊酸盐、左乙拉西坦或托吡酯）的地位尚待确定。
