Lacey D J
Department of Neurology, Wright State University, Dayton, Ohio.
J Clin Psychiatry. 1988 Dec;49 Suppl:33-6.
Status epilepticus (SE) is defined as a continuous seizure that lasts more than 30 minutes or as serial seizures in which the patient does not regain a premorbid level of consciousness. This condition exists primarily in two forms: convulsive (focal or generalized) and nonconvulsive (absence or partial complex) SE. Protracted or serial convulsive seizures represent a medical emergency with a current mortality rate of 10%. As in any urgent or life-threatening situation, the initial treatment is directed at support and maintenance of vital functions. Specific anticonvulsant management is usually begun with intravenous lorazepam. This benzodiazepine is replacing diazepam in many medical centers because it has a longer duration of action and causes less respiratory depression. Concurrent intravenous loading with phenytoin is usually necessary for sustained control of seizures. Phenobarbital may be required as a third drug if seizures persist or recur. In cases of refractory status epilepticus, barbiturate coma, continuous anticonvulsant intravenous infusion, or general anesthesia may be necessary.
癫痫持续状态（SE）的定义为持续超过30分钟的连续性癫痫发作，或患者未恢复到病前意识水平的连续性癫痫发作。这种情况主要有两种形式：惊厥性（局灶性或全身性）和非惊厥性（失神或部分复杂性）癫痫持续状态。持续性或连续性惊厥性癫痫发作是一种医疗急症，目前死亡率为10%。与任何紧急或危及生命的情况一样，初始治疗旨在支持和维持重要功能。特异性抗惊厥治疗通常从静脉注射劳拉西泮开始。这种苯二氮䓬类药物在许多医疗中心正取代地西泮，因为它作用持续时间更长，且引起的呼吸抑制较少。通常需要同时静脉注射负荷量苯妥英钠以持续控制癫痫发作。如果癫痫发作持续或复发，可能需要使用苯巴比妥作为第三种药物。在难治性癫痫持续状态的情况下，可能需要巴比妥类昏迷、持续抗惊厥静脉输注或全身麻醉。
