Gómez-Ibáñez Asier, Urrestarazu Elena, Viteri César
Unidad de Epilepsia, Departamento de Neurología, Clínica Universidad de Navarra, Pamplona, Navarra, España.
Rev Neurol. 2012 Jan 16;54(2):105-13.
Non-convulsive status epilepticus is a significant issue for a neurologist because, despite its low prevalence, it mimics other pathologies, with therapeutics and prognostic outcomes. Diagnosis is based on clinical features, mainly mental status or impaired consciousness and electroencephalographic changes, so electroencephalogram is the first exploration we must perform with clinical suspicion. There are three clinical forms: generalized or absence status, with diffuse epileptiform discharges; focal, with epileptic discharges located in a specific brain area and may not affect consciousness; and subtle, with diffuse or local epileptic activity after a tonic-clonic seizure or convulsive status and limited or no motor activity. Treatment are benzodiazepines and antiepileptic drugs; anesthetic drugs are only recommended for patients with subtle status and in some with partial complex status. Prognosis is mainly determined by etiology and associated brain damage.
非惊厥性癫痫持续状态是神经科医生面临的一个重要问题,因为尽管其发病率较低,但它会模仿其他病症,并影响治疗方法和预后结果。诊断基于临床特征,主要是精神状态或意识障碍以及脑电图变化,因此脑电图是临床怀疑时必须首先进行的检查。有三种临床形式:全身性或失神状态,伴有弥漫性癫痫样放电;局灶性,癫痫放电位于特定脑区,可能不影响意识;隐匿性,在强直阵挛发作或惊厥性癫痫持续状态后出现弥漫性或局部癫痫活动,运动活动有限或无运动活动。治疗药物为苯二氮䓬类药物和抗癫痫药物;麻醉药物仅推荐用于隐匿性癫痫持续状态患者以及部分复杂癫痫持续状态患者。预后主要由病因和相关脑损伤决定。