Department of Neurology, University of California, San Francisco, CA, USA.
Department of Neurology, University of California, San Francisco, CA, USA.
Lancet Neurol. 2015 Jun;14(6):615-24. doi: 10.1016/S1474-4422(15)00042-3. Epub 2015 Apr 20.
Status epilepticus is a common neurological emergency with considerable associated health-care costs, morbidity, and mortality. The definition of status epilepticus as a prolonged seizure or a series of seizures with incomplete return to baseline is under reconsideration in an effort to establish a more practical definition to guide management. Clinical research has focused on early seizure termination in the prehospital setting. The approach of early escalation to anaesthetic agents for refractory generalised convulsive status epilepticus, rather than additional trials of second-line anti-epileptic drugs, to avoid neuronal injury and pharmaco-resistance associated with prolonged seizures is gaining momentum. Status epilepticus is also increasingly identified in the inpatient setting as the use of extended electroencephalography monitoring becomes more commonplace. Substantial further research to enable early identification of status epilepticus and efficacy of anti-epileptic drugs will be important to improve outcomes.
癫痫持续状态是一种常见的神经系统急症,会带来相当大的医疗保健费用、发病率和死亡率。目前正在重新考虑将癫痫持续状态定义为长时间发作或一系列发作且无法完全恢复到基线,以建立更实用的定义来指导治疗。临床研究主要集中在院前环境中尽早终止发作。对于难治性全面性强直-阵挛性癫痫持续状态,早期升级使用麻醉剂,而不是进一步尝试二线抗癫痫药物,以避免与长时间发作相关的神经元损伤和药物耐药性,这种方法越来越受到关注。随着扩展脑电图监测的使用变得更加普遍,癫痫持续状态也越来越多地在住院患者中被发现。为了改善预后,重要的是要进行更多的研究,以实现对癫痫持续状态的早期识别和抗癫痫药物的疗效。