Waterhouse Elizabeth
Continuum (Minneap Minn). 2010 Jun;16(3 Epilepsy):199-227. doi: 10.1212/01.CON.0000368239.87728.59.
Status epilepticus (SE) is one of the most commonly occurring neurologic emergencies. About 40% of SE cases occur in people with epilepsy. Convulsive SE is easily recognized, but nonconvulsive SE is not and requires both a high index of suspicion and EEG confirmation. SE has a high mortality risk and requires rapid effective treatment for optimal response to therapy and outcome. The goal of treatment is to stop all clinical and electrographic seizures while maintaining vital functions. If seizures continue after initial treatment with a benzodiazepine, additional antiepileptic therapy should be administered. When SE is refractory to these treatments, continuous IV infusion with midazolam, propofol, or a barbiturate suppresses seizure activity. Standard treatment protocols are useful in promoting rapid intervention with appropriate medications.
癫痫持续状态(SE)是最常见的神经系统急症之一。约40%的SE病例发生在癫痫患者中。惊厥性SE易于识别,但非惊厥性SE则不然,需要高度怀疑并通过脑电图确认。SE具有较高的死亡风险,需要迅速有效的治疗以获得最佳治疗反应和预后。治疗的目标是在维持生命功能的同时停止所有临床和脑电图发作。如果在最初使用苯二氮䓬类药物治疗后癫痫发作仍持续,应给予额外的抗癫痫治疗。当SE对这些治疗无效时,持续静脉输注咪达唑仑、丙泊酚或巴比妥类药物可抑制癫痫发作活动。标准治疗方案有助于促进使用适当药物进行快速干预。