Feen Eliahu S, Bershad Eric M, Suarez Jose I
Division of Vascular Neurology and Neurocritical Care, Department of Neurology, Baylor College of Medicine, Houston, TX 77030, USA.
South Med J. 2008 Apr;101(4):400-6. doi: 10.1097/SMJ.0b013e31816852b0.
Status epilepticus (SE) in adults is a state of continuous seizures lasting more than 5 minutes, or rapidly recurrent seizures without regaining consciousness. The overall US and European estimated crude incidence rate of SE ranges from 6.8 to 41/100,000/yr. The etiologies of SE include primary central nervous system pathologies and systemic disorders. The two basic mechanisms involved in the genesis of SE are an excess of excitatory activity and a loss of normal inhibitory neurotransmission. Mortality associated with SE can be as high as 26% for the average adult. Early recognition and treatment are important for improving the chances for a good outcome. The first line of treatment is an intravenous benzodiazepine, with lorazepam being the current preferred agent. All patients with SE who remain with altered awareness 20 to 30 minutes after cessation of clinical seizures should undergo electroencephalographic studies, because up to 20% of patients without clinical evidence of seizures after initial treatment can have nonconvulsive SE.
成人癫痫持续状态（SE）是指持续发作超过5分钟的连续癫痫发作状态，或迅速反复癫痫发作且未恢复意识。美国和欧洲总体估计的SE粗发病率为每年6.8至41/10万。SE的病因包括原发性中枢神经系统病变和全身性疾病。SE发生的两个基本机制是兴奋性活动过度和正常抑制性神经传递丧失。普通成年人中与SE相关的死亡率可能高达26%。早期识别和治疗对于提高良好预后的机会很重要。一线治疗是静脉注射苯二氮䓬类药物，目前首选药物是劳拉西泮。所有临床癫痫发作停止后20至30分钟意识仍有改变的SE患者均应接受脑电图检查，因为初始治疗后无癫痫发作临床证据的患者中，高达20%可能患有非惊厥性SE。
