Romero-Osorio O M, Abaunza-Camacho J F, Sandoval-Briceno D
Pontificia Universidad Javeriana, Bogota DC, Colombia.
Rev Neurol. 2019 Apr 16;68(8):339-345. doi: 10.33588/rn.6808.2018356.
Postictal neurogenic pulmonary oedema is an infrequent condition of varying severity, probably related to sudden unexpected death in epilepsy (SUDEP). It is more frequent in patients with generalised tonic-clonic seizures of long duration or with status epilepticus.
Based on a review of the literature, the aim is to describe the clinical characteristics, pathophysiology, radiological findings, treatment and prognosis of patients with postictal pulmonary oedema.
A search of the literature was performed in the PubMed, Embase, Cochrane Database of Systematic Reviews and BVS databases using a combination of free terms. The limits of the search applied were: papers published between 1 January 2000 and 26 April 2018, and papers for which the abstract was available. Altogether 23 papers were found, most of which were clinical cases, and used to extract the information needed to carry out the review.
In postictal pulmonary oedema, generalised tonic-clonic seizures are the most frequently reported type. The most common clinical manifestations were dyspnoea and tachycardia appearing within a few minutes after the seizure. Among the paraclinical findings the most frequent was leukocytosis. In general terms, a good prognosis was found in most cases, with improvement of the oedema within a period of between 12 and 96 hours. Only two of the 21 patients reported died. In addition, in a clinical pathology study in patients with SUDEP, pulmonary oedema appeared in most cases.
发作后神经源性肺水肿是一种严重程度各异的罕见病症，可能与癫痫猝死（SUDEP）相关。在长时间全身性强直阵挛发作或癫痫持续状态的患者中更为常见。
基于文献综述，目的是描述发作后肺水肿患者的临床特征、病理生理学、影像学表现、治疗及预后。
在PubMed、Embase、Cochrane系统评价数据库和BVS数据库中使用自由词组合进行文献检索。检索范围限制为：2000年1月1日至2018年4月26日发表的论文，以及有摘要的论文。共找到23篇论文，其中大部分为临床病例，用于提取进行综述所需的信息。
在发作后肺水肿中，全身性强直阵挛发作是最常报告的类型。最常见的临床表现是发作后几分钟内出现的呼吸困难和心动过速。在辅助检查结果中，最常见的是白细胞增多。总体而言，大多数病例预后良好，水肿在12至96小时内改善。报告的21例患者中仅有2例死亡。此外，在一项关于SUDEP患者的临床病理研究中，大多数病例出现了肺水肿。
