Millikan Dan, Rice Brian, Silbergleit Robert
Department of Emergency Medicine, University of Michigan Neuro Emergencies Research, Ann Arbor, MI 48106, USA.
Emerg Med Clin North Am. 2009 Feb;27(1):101-13, ix. doi: 10.1016/j.emc.2008.12.001.
Current thinking about the acute treatment of status epilepticus (SE) emphasizes a more aggressive clinical approach to this common life-threatening neurologic emergency. In this review, the authors consider four concepts that can accelerate effective treatment of SE. These include (1) updating the definition of SE to make it more clinically relevant, (2) consideration of faster ways to initiate first-line benzodiazepine therapy in the prehospital environment, (3) moving to second-line agents more quickly in refractory status in the emergency department, and (4) increasing detection and treatment of unrecognized nonconvulsive SE in comatose neurologic emergency patients.
目前关于癫痫持续状态（SE）急性治疗的思路强调，对于这种常见的危及生命的神经系统急症，应采取更积极的临床治疗方法。在本综述中，作者探讨了四个可加速SE有效治疗的概念。这些概念包括：（1）更新SE的定义，使其更具临床相关性；（2）考虑在院前环境中更快地启动一线苯二氮䓬类药物治疗的方法；（3）在急诊科对于难治性状态更快地使用二线药物；（4）加强对昏迷神经系统急症患者中未被识别的非惊厥性SE的检测和治疗。
