Department of Neurology, Harvard Medical School, and Comprehensive Epilepsy Center, Beth Israel Deaconess Medical Center, Boston, MA 02215, USA.
Epilepsy Behav. 2011 Oct;22(2):342-5. doi: 10.1016/j.yebeh.2011.07.013. Epub 2011 Aug 16.
Several studies have shown reliable predictive factors for outcome in status epilepticus (SE), especially etiology and presentation in coma. Duration of SE is predictive, but probably only in the first few hours, and there have been many reports of patients treated successfully for SE lasting many days or weeks. Nevertheless, there are many other patients with SE treated for prolonged periods without success, sometimes apparently futilely. We compared clinical features of 10 survivors of prolonged SE with those of a matched cohort treated for similarly prolonged episodes but unsuccessfully, looking for exceptions to known predictive factors. Multiple medical problems (i.e., etiologies) and coma on presentation were confirmed as predictors of a poor outcome. Analysis of individual exceptions to these predictors showed that age, overall background health, and family input on the value of prolonged treatment, on the one hand, and earlier epilepsy plus rapid and accurate diagnosis and treatment, on the other, contributed to results different from what would have been expected.
多项研究表明，癫痫持续状态（SE）的结局存在可靠的预测因素，尤其是病因和昏迷时的表现。SE 的持续时间具有预测价值，但可能仅在最初的几个小时内，并且有许多关于成功治疗持续数天或数周的 SE 患者的报道。然而，也有许多其他 SE 患者接受了长时间的治疗但没有成功，有时显然是徒劳的。我们比较了 10 例长时间 SE 幸存者的临床特征与一组经同样长时间治疗但未成功的匹配队列的特征，以寻找已知预测因素的例外。多种医疗问题（即病因）和发作时昏迷被确认为预后不良的预测因素。对这些预测因素的个体例外情况进行分析表明，一方面，年龄、整体健康状况以及家庭对延长治疗价值的投入，以及另一方面，早期癫痫发作加上快速准确的诊断和治疗，导致了与预期结果不同的结果。
