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[难治性和超难治性癫痫持续状态的管理]

[Management of refractory and super-refractory status epilepticus].

作者信息

Erbguth Frank

机构信息

Klinik für Neurologie, Klinikum Nürnberg, Paracelsus Medizinische Privatuniversität, Breslauer Str. 201, 90471, Nürnberg, Deutschland.

出版信息

Med Klin Intensivmed Notfmed. 2019 Oct;114(7):628-634. doi: 10.1007/s00063-019-00610-0. Epub 2019 Aug 28.

Abstract

If status epilepticus continues despite the use of intravenous antiepileptic drugs or narcotics, it is called "refractory" or "super-refractory" status epilepticus (RSE, SRSE). Prolonged seizure activity is associated with neuronal damage, systemic complications and mortality rates of up to 50%, especially in generalized tonic clonic seizure types. In order to terminate the status, several rescue interventions with drugs and other measures are available. However, their evidence base is low because the effectiveness of the measures was almost exclusively derived from case reports and case series. In individual cases, a good outcome is possible even after several months of ongoing SRSE.

摘要

尽管使用了静脉注射抗癫痫药物或麻醉药物,但癫痫持续状态仍持续存在,则称为“难治性”或“超难治性”癫痫持续状态(RSE,SRSE)。长时间的癫痫发作活动与神经元损伤、全身并发症以及高达50%的死亡率相关,尤其是在全身强直阵挛性癫痫发作类型中。为了终止这种状态,可以采用几种药物及其他措施的抢救干预。然而,它们的证据基础薄弱,因为这些措施的有效性几乎完全来自病例报告和病例系列。在个别案例中,即使在SRSE持续数月之后,也可能有良好的预后。

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