通过振幅整合脑电图和两通道简化脑电图相结合的床边监测诊断出的非惊厥性癫痫持续状态的成功治疗。

Successful treatment of non-convulsive status epilepticus diagnosed using bedside monitoring by a combination of amplitude-integrated and two-channel simplified electroencephalography.

作者信息

Egawa Satoshi, Hifumi Toru, Kawakita Kenya, Manabe Arisa, Matumura Hikari, Okazaki Tomoya, Hamaya Hideyuki, Shinohara Natuyo, Shishido Hajime, Takano Koshiro, Abe Yuko, Hagiike Masanobu, Kuroda Yasuhiro

机构信息

Emergency Medical Center Kagawa University Hospital Miki Kagawa Japan.

出版信息

Acute Med Surg. 2015 Aug 27;3(2):167-170. doi: 10.1002/ams2.156. eCollection 2016 Apr.

DOI:10.1002/ams2.156

PMID:29123774

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5667393/

Abstract

CASE

A 66-year-old man developed disturbed consciousness and right hemiparesis with transient convulsions in the right arm. Bedside monitoring using a combination of amplitude-integrated electroencephalography and two-channel simplified electroencephalography revealed intermittent episodes of 1-3 Hz δ waves lasting for approximately 5 min, consistent with non-convulsive status epilepticus. Fosphenytoin (22.5 mg/kg/day) and levetiracetam (1,000 mg) prevented right arm convulsions but did not restore consciousness. The two-channel simplified electroencephalography also showed an intermittent periodic δ wave pattern in the Fp1-C3 channel. Conventional electroencephalography revealed a polymorphic δ activity that was abolished by 2.5 mg diazepam, thus confirming the diagnosis of non-convulsive status epilepticus.

OUTCOME

The patient recovered completely with the antiepileptic drug combination.

CONCLUSION

Immediate initiation of bedside monitoring using amplitude-integrated electroencephalography and two-channel simplified electroencephalography allows early detection of non-convulsive status epilepticus in patients with disturbed consciousness, which considerably improves the prognosis.

摘要

病例

一名66岁男性出现意识障碍和右侧偏瘫，右臂有短暂抽搐。采用振幅整合脑电图和双通道简化脑电图相结合的床边监测显示，有持续约5分钟的1 - 3Hz δ波间歇性发作，符合非惊厥性癫痫持续状态。磷苯妥英（22.5mg/kg/天）和左乙拉西坦（1000mg）可预防右臂抽搐，但未恢复意识。双通道简化脑电图在Fp1 - C3通道也显示出间歇性周期性δ波模式。常规脑电图显示多形性δ活动，静脉注射2.5mg地西泮后该活动消失，从而确诊为非惊厥性癫痫持续状态。

结果

患者使用抗癫痫药物联合治疗后完全康复。

结论

立即采用振幅整合脑电图和双通道简化脑电图进行床边监测，能够早期发现意识障碍患者的非惊厥性癫痫持续状态，这可显著改善预后。

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