Chou I-Ching, Lai Huan-Cheng, Tsai Fuu-Jen, Chang Yu-Tzu, Lin Sheng-Shing, Hong Syuan-Yu, Lee Inn-Chi
Department of Pediatrics, Children's Hospital, China Medical University Hospital, Taichung, Taiwan; Graduate Institute of Integrated Medicine, College of Chinese Medicine, China Medical University, Taichung, Taiwan.
Department of Pediatrics, Children's Hospital, China Medical University Hospital, Taichung, Taiwan.
Epilepsy Behav Case Rep. 2016 Jun 2;6:6-9. doi: 10.1016/j.ebcr.2016.05.002. eCollection 2016.
This report sheds light on a successful treatment in febrile infection-related epilepsy syndrome (FIRES) with the combined use of lidocaine and MgSO4.
We report a 12-year-old previously healthy girl who experienced an upper respiratory infection with fever and headache for 2 days, then suddenly went into a coma followed by repetitive status epilepticus. All tests for CNS infection, metabolic and toxic diseases, and autoimmune encephalitis were negative. Hence, the diagnosis of FIRES was made. During 5 weeks of hospital treatment, various antiepileptic drugs were administered at different times without success. To achieve seizure control, we then attempted the use of lidocaine first, then followed by MgSO4.
The SE was successfully controlled when lidocaine plus MgSO4 was introduced. At follow-up, almost no neurological sequelae remained.
This is the first report describing the combined use of lidocaine and MgSO4 with successful treatment outcomes. This experience has indicated that even FIRES can be controlled if treated promptly with certain agents. However, more studies are needed to explore the mechanisms and effects of lidocaine and MgSO4 in FIRES.
本报告揭示了利多卡因和硫酸镁联合使用成功治疗发热感染相关癫痫综合征（FIRES）的案例。
我们报告了一名12岁的既往健康女孩，她因上呼吸道感染伴发热和头痛2天，随后突然昏迷，继而出现反复癫痫持续状态。所有中枢神经系统感染、代谢和中毒性疾病以及自身免疫性脑炎的检查均为阴性。因此，诊断为FIRES。在住院治疗的5周内，不同时间使用了各种抗癫痫药物，但均未成功。为了控制癫痫发作，我们先尝试使用利多卡因，然后使用硫酸镁。
引入利多卡因加硫酸镁后，癫痫持续状态成功得到控制。随访时，几乎没有遗留神经后遗症。
这是第一篇描述利多卡因和硫酸镁联合使用取得成功治疗效果的报告。这一经验表明，即使是FIRES，如果及时用某些药物治疗也可以得到控制。然而，需要更多的研究来探索利多卡因和硫酸镁在FIRES中的作用机制和效果。
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