Bennett Alicia E, Hoesch Robert E, DeWitt L Dana, Afra Pegah, Ansari Safdar A
University of Utah, Neurology Department, 175 N. Medical Dr. East, 5th Floor, Salt Lake City 84132, USA.
Intermountain Medical Center, Neurology Department, 5171 S. Cottonwood St. Ste 810, Salt Lake City 84107, USA.
Clin Neurol Neurosurg. 2014 Nov;126:103-9. doi: 10.1016/j.clineuro.2014.08.032. Epub 2014 Sep 4.
Refractory status epilepticus is a disease associated with high morbidity and mortality, which does not always respond to standard treatments, and when they fail, alternative modalities become crucial. Therapeutic hypothermia slows nerve conduction in vitro, and has been shown to abort seizures in animal models. Therapeutic hypothermia has been experimentally used in humans since 1963 for a variety of intracranial pathologies. More recently there have been multiple reports demonstrating the effectiveness of therapeutic hypothermia in treating refractory status epilepticus. We report a case of super-refractory status epilepticus successfully treated with therapeutic hypothermia, complimented by a historical and literature review of this modality. While there is limited evidence, and some risks associated with therapeutic hypothermia, it should be considered as a reasonable and potentially effective treatment option for refractory status epilepticus.
难治性癫痫持续状态是一种发病率和死亡率都很高的疾病,它对标准治疗并不总是有反应,当标准治疗失败时,替代治疗方法就变得至关重要。治疗性低温在体外会减慢神经传导,并且已在动物模型中显示可终止癫痫发作。自1963年以来,治疗性低温已在人体中进行实验性应用,用于治疗各种颅内病变。最近,有多项报告证明治疗性低温在治疗难治性癫痫持续状态方面的有效性。我们报告了一例通过治疗性低温成功治疗的超级难治性癫痫持续状态病例,并对这种治疗方法进行了历史回顾和文献综述。虽然证据有限,且治疗性低温存在一些风险,但它应被视为难治性癫痫持续状态的一种合理且可能有效的治疗选择。