Service de Neurophysiologie Clinique, Centre Hospitalier Universitaire Pellegrin, Bordeaux, France.
Seizure. 2012 Nov;21(9):661-4. doi: 10.1016/j.seizure.2012.07.010. Epub 2012 Aug 9.
Refractory status epilepticus (SE) is a current daily therapeutic challenge. Electroconvulsive therapy (ECT), which is frequently used to treat psychiatric disorders, is known to raise the seizure threshold. As such, ECT could be of major interest in refractory SE. In this paper, we provide a brief overview of ECT in refractory SE. Although no placebo-controlled or open-label study has been published on the efficacy or safety of ECT in refractory SE, eight case reports have been identified. SE cessation was obtained in 80% of cases, and complete recovery was achieved in 27% of patients. Despite the heterogeneity of the ECT parameters used in these articles, we identified some common features that may be recommended for the use of ECT in refractory SE. ECT might be a viable therapeutic strategy for the most resistant and severe cases of SE, particularly after the failure of two inductions of anesthetic coma. This potential indication highlights the urgent need for clinical trials that assess the usefulness of ECT in refractory SE.
难治性癫痫持续状态（SE）是目前每日治疗的挑战。电休克疗法（ECT）常用于治疗精神疾病，已知其可提高癫痫发作阈值。因此，ECT 在难治性 SE 中可能具有重要意义。本文简要概述了难治性 SE 中的 ECT。尽管没有安慰剂对照或开放标签研究发表 ECT 在难治性 SE 中的疗效或安全性，但已确定了 8 例病例报告。80%的病例停止了 SE，27%的患者完全恢复。尽管这些文章中 ECT 参数的异质性很大，但我们确定了一些可能推荐用于难治性 SE 的 ECT 的共同特征。ECT 可能是最顽固和严重 SE 病例的可行治疗策略，尤其是在两次麻醉诱导昏迷失败后。这一潜在适应证突出表明迫切需要临床试验来评估 ECT 在难治性 SE 中的有效性。
