Buompadre María Celeste
Hospital de Pediatría Prof. Dr. Juan P. Garrahan, Buenos Aires, Argentina. E-mail:
Medicina (B Aires). 2018;78 Suppl 2:12-17.
Status epilepticus (SE) is one of the most common neurologic emergencies in pediatrics. It is a condition resulting either from the failure of the mechanisms responsible for seizure termination or from the initiation of mechanisms, which leads to abnormally, prolonged seizures. This definition provides a good guidance, when emergency treatment must be considered. In general, time point t1 is the time when treatment should be started, which is at 5 minutes for generalized tonic-clonic seizures, and at 10 min for focal seizures with or without impairment of consciousness. Time-point t2 marks the time at which neuronal damage or self-perpetuating alteration of neuronal networks may begin and indicates that SE should be controlled latest by that time; 30 min in case of generalized tonic-clonic seizures. All treatment protocols recognize a staged approach to treatment with different drugs used in early (stage I), established (stage II), refractory (stage III) and super-refractory SE (stage IV); and emphasize prompt recognition and treatment of persisting seizure activity at each stage aiming to reduce morbidity, mortality, and long-term consequences of status epilepticus (beyond t2).
癫痫持续状态（SE）是儿科最常见的神经系统急症之一。它是由负责终止癫痫发作的机制失败或导致异常、长时间癫痫发作的机制启动所引起的一种病症。当必须考虑进行紧急治疗时，这个定义提供了很好的指导。一般来说，时间点t1是开始治疗的时间，全身性强直阵挛性发作是在5分钟时，伴有或不伴有意识障碍的局灶性发作是在10分钟时。时间点t2标志着神经元损伤或神经网络自我持续改变可能开始的时间，并表明癫痫持续状态应最迟在该时间得到控制；全身性强直阵挛性发作的情况下是30分钟。所有治疗方案都认可一种分阶段的治疗方法，在早期（I期）、确立期（II期）、难治期（III期）和超难治性癫痫持续状态（IV期）使用不同的药物；并强调在每个阶段迅速识别和治疗持续的癫痫发作活动，旨在降低癫痫持续状态（超过t2）的发病率、死亡率和长期后果。
