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[癫痫持续状态]

[Status epilepticus].

作者信息

Feddersen B, Trinka E

机构信息

Epilepsie-Zentrum, Neurologische Klinik, Klinikum der Universität München - Großhadern, Marchioninistr.15, 81377, München, Deutschland.

出版信息

Nervenarzt. 2012 Feb;83(2):187-94. doi: 10.1007/s00115-011-3337-0.

Abstract

Status epilepticus (SE) is a medical emergency. For diagnostic purposes EEG is mandatory when motor phenomena are absent or when a single seizure evolves into SE with impaired consciousness. The EEG may show focal or generalized status patterns, which must be distinguished from encephalopathies. Initially benzodiazepines are recommended; lorazepam is the drug of choice. When the SE persists, phenytoin, valproate, levetiracetam, lacosamide, and phenobarbital are administered. The choice depends on the underlying comorbidities. In this phase, only phenytoin is licensed. A generalized tonic-clonic status which is refractory is then treated with anesthetics including midazolam, disoprivan, or thiopental. The goal is to achieve burst suppression in the EEG and coadministration of antiepileptic drugs.

摘要

癫痫持续状态(SE)是一种医疗急症。为了诊断目的,当没有运动现象或单次癫痫发作演变为伴有意识障碍的癫痫持续状态时,脑电图(EEG)是必需的。脑电图可能显示局灶性或全身性癫痫持续状态模式,必须将其与脑病区分开来。最初推荐使用苯二氮䓬类药物;劳拉西泮是首选药物。当癫痫持续状态持续时,给予苯妥英钠、丙戊酸盐、左乙拉西坦、拉科酰胺和苯巴比妥。选择取决于潜在的合并症。在此阶段,只有苯妥英钠获得许可。然后,对于难治性全身性强直阵挛性癫痫持续状态,使用包括咪达唑仑、丙泊酚或硫喷妥钠在内麻醉剂进行治疗。目标是在脑电图中实现爆发抑制并联合使用抗癫痫药物。

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