小儿难治性癫痫持续状态的低温治疗。
Hypothermia for pediatric refractory status epilepticus.
机构信息
Division of Pediatric and Developmental Neurology, Department of Neurology, Washington University in St. Louis, St. Louis, Missouri, USA.
出版信息
Epilepsia. 2013 Sep;54(9):1586-94. doi: 10.1111/epi.12331. Epub 2013 Aug 1.
PURPOSE
Refractory status epilepticus (RSE) is a life-threatening emergency, demonstrating, by definition, significant pharmacoresistance. We describe five cases of pediatric RSE treated with mild hypothermia.
METHODS
Retrospective chart review was performed of records of children who received hypothermia for RSE at two tertiary-care pediatric hospitals between 2009 and 2012.
KEY FINDINGS
Five children with RSE received mild hypothermia (32-35°C). Hypothermia reduced seizure burden during and after treatment in all cases. Prior to initiation of hypothermia, four children (80%) received pentobarbital infusions to treat RSE, but relapsed after pentobarbital discontinuation. No child relapsed after treatment with hypothermia. One child died after redirection of care. Remaining four children were discharged.
SIGNIFICANCE
This is the largest pediatric case series reporting treatment of RSE with mild hypothermia. Hypothermia decreased seizure burden during and after pediatric RSE and may prevent RSE relapse.
目的
难治性癫痫持续状态（RSE）是一种危及生命的紧急情况，根据定义，其表现出明显的药物抵抗性。我们描述了五例接受亚低温治疗的儿科 RSE 病例。
方法
对 2009 年至 2012 年间在两家三级儿童医院接受亚低温治疗 RSE 的患儿的病历进行了回顾性图表审查。
主要发现
五例 RSE 患儿接受了亚低温（32-35°C）治疗。在所有病例中，亚低温均降低了治疗期间和治疗后的癫痫发作负担。在开始亚低温治疗之前，有 4 名患儿（80%）接受了戊巴比妥输注以治疗 RSE，但在戊巴比妥停药后复发。没有患儿在接受亚低温治疗后复发。一名患儿在转院后死亡。其余 4 名患儿出院。
意义
这是最大的儿科病例系列报告，用亚低温治疗 RSE。亚低温降低了儿科 RSE 期间和之后的癫痫发作负担，并可能预防 RSE 复发。
Zotero 插件