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缺氧后癫痫持续状态应积极治疗吗?——不!

Should Postanoxic Status Epilepticus be Treated Aggressively?-No!

作者信息

Rossetti Andrea O

机构信息

Department of Clinical Neurosciences, Centre Hospitalier Universitaire Vaudois (CHUV) and University of Lausanne, Lausanne, Switzerland.

出版信息

J Clin Neurophysiol. 2015 Dec;32(6):447-8. doi: 10.1097/WNP.0000000000000208.

Abstract

Electrographic status epilepticus and myoclonus represent frequent findings in patients surviving cardiac arrest; both features have been related to poor clinical outcome. Recent data have outlined that status epilepticus appearing during therapeutic hypothermia and sedation is practically and invariably related to a fatal issue, as opposed to some patients presenting status epilepticus and/or myoclonus after return to normothermic conditions. Although it seems reasonable to give a chance of awakening to the latter patients by administering consequent antiepileptic treatment, especially if other favorable prognostic markers are observed, an aggressive treatment of status epilepticus arising during hypothermia seems futile in view of the existing evidence.

摘要

脑电图癫痫持续状态和肌阵挛是心脏骤停存活患者的常见表现;这两种特征均与不良临床结局相关。近期数据表明,治疗性低温和镇静期间出现的癫痫持续状态实际上总是与致命问题相关,这与一些患者在恢复正常体温后出现癫痫持续状态和/或肌阵挛的情况相反。尽管给予后一类患者后续抗癫痫治疗以使其有苏醒机会似乎是合理的,尤其是在观察到其他有利预后标志物的情况下,但鉴于现有证据,对低温期间出现的癫痫持续状态进行积极治疗似乎是徒劳的。

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