Claassen Jan, Riviello James J, Silbergleit Robert
Division of Critical Care Neurology, Columbia University College of Physicians & Surgeons, New York, USA.
Division of Child Neurology, Columbia University College of Physicians & Surgeons, New York, USA.
Neurocrit Care. 2015 Dec;23 Suppl 2:S136-42. doi: 10.1007/s12028-015-0172-3.
Patients with prolonged or rapidly recurring convulsions lasting more than 5 min are in status epilepticus (SE) and require immediate resuscitation. Although there are relatively few randomized clinical trials, available evidence and experience suggest that early and aggressive treatment of SE improves patient outcomes, for which reason this was chosen as an Emergency Neurological Life Support protocol. The current approach to the emergency treatment of SE emphasizes rapid initiation of adequate doses of first-line therapy, as well as accelerated second-line anticonvulsant drugs and induced coma when these fail, coupled with admission to a unit capable of neurological critical care and electroencephalography monitoring. This protocol will focus on the initial treatment of SE but also review subsequent steps in the protocol once the patient is hospitalized.
惊厥持续时间延长或迅速复发且持续超过5分钟的患者处于癫痫持续状态(SE),需要立即进行复苏。尽管随机临床试验相对较少,但现有证据和经验表明,对SE进行早期积极治疗可改善患者预后,因此将其选为紧急神经生命支持方案。目前SE的紧急治疗方法强调迅速开始使用足够剂量的一线治疗药物,以及在一线治疗失败时加速使用二线抗惊厥药物并诱导昏迷,同时将患者收入能够进行神经重症监护和脑电图监测的科室。本方案将侧重于SE的初始治疗,但也会在患者住院后回顾方案中的后续步骤。