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神经刺激治疗难治性和超难治性癫痫持续状态。

Neurostimulation in the treatment of refractory and super-refractory status epilepticus.

机构信息

Department of Neurology, Christian Doppler Klinik, Paracelsus Medical University, Salzburg, Austria; Center for Cognitive Neuroscience, Salzburg, Austria; Public Health, Health Services Research and HTA, University for Health Sciences, Medical Informatics and Technology, Hall i.T., Austria.

Department of Neuroscience, Biomedicine and Movement, University of Verona, Italy; Department of Neurology, Franz Tappeiner Hospital, Merano, Italy.

出版信息

Epilepsy Behav. 2019 Dec;101(Pt B):106551. doi: 10.1016/j.yebeh.2019.106551. Epub 2019 Oct 30.

Abstract

Status epilepticus (SE) is a life-threatening condition with a mortality of up to 60% in the advanced and comatose forms of SE. In one out of five adults, first and second line fails to control epileptic activity, leading to refractory status epilepticus (RSE) and in around 3% to super-refractory status epilepticus (SRSE), where SE continues despite anesthetic treatment for 24 h or more. In this rare but devastating condition, innovative and safe treatments are needed. In a recent review on the use of vagal nerve stimulation in RSE and SRSE, a 74% response rate for abrogation of SE was reported. Here, we review the currently available evidence supporting the use of neurostimulation, including vagal nerve stimulation, direct cortical stimulation, transcranial magnetic stimulation, electroconvulsive therapy, and deep brain stimulation in RSE and SRSE. This article is part of the Special Issue "Proceedings of the 7th London-Innsbruck Colloquium on Status Epilepticus and Acute Seizures".

摘要

癫痫持续状态(SE)是一种危及生命的疾病,在晚期和昏迷的 SE 形式中,死亡率高达 60%。在五分之一的成年人中,一线和二线治疗未能控制癫痫活动,导致难治性癫痫持续状态(RSE),约 3%发展为超难治性癫痫持续状态(SRSE),尽管进行了 24 小时或更长时间的麻醉治疗,但 SE 仍持续存在。在这种罕见但具有破坏性的情况下,需要创新和安全的治疗方法。在最近一篇关于迷走神经刺激在 RSE 和 SRSE 中的应用的综述中,报道了 SE 缓解的应答率为 74%。在这里,我们回顾了目前支持神经刺激(包括迷走神经刺激、直接皮质刺激、经颅磁刺激、电惊厥疗法和深部脑刺激)在 RSE 和 SRSE 中应用的现有证据。本文是“第七届伦敦-因斯布鲁克癫痫持续状态和急性发作学术研讨会论文集”特刊的一部分。

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