Fagan K J, Lee S I
Department of Neurology, University of Virginia School of Medicine, Charlottesville.
Neurology. 1990 Nov;40(11):1689-94. doi: 10.1212/wnl.40.11.1689.
Among patients with a prolonged confusional state after convulsive seizure, we diagnosed 8 cases as generalized nonconvulsive status epilepticus. Six had a history of seizures, and 2 had new onset. The convulsive seizures were generalized in 6 and focal in two. The postictal confusion lasted up to 36 hours in the most prolonged case, and a delayed response to anticonvulsant medications occurred in all cases. The clinical symptoms ranged from mild confusion to coma. Psychiatric manifestations or automatisms were rare. The presumed etiology was due to diverse causes, but a withdrawal state was the most common. EEG demonstrated continuous or nearly continuous generalized ictal discharges of variable morphology. These cases call attention to the fact that some prolonged confusional states following convulsive seizures are in fact due to persistent seizure activity that can be diagnosed by EEG.
在惊厥发作后出现长时间意识模糊状态的患者中，我们将8例诊断为全身性非惊厥性癫痫持续状态。其中6例有癫痫发作史，2例为新发。惊厥发作全身性的有6例，局灶性的有2例。在最长的病例中，发作后意识模糊持续长达36小时，所有病例对抗惊厥药物的反应均延迟。临床症状从轻度意识模糊到昏迷不等。精神症状或自动症很少见。推测病因多种多样，但戒断状态最为常见。脑电图显示形态各异的持续性或近乎持续性全身性发作期放电。这些病例提醒人们注意，惊厥发作后的一些长时间意识模糊状态实际上是由持续性癫痫活动所致，可通过脑电图诊断。
