Medico-Surgical Intensive Care Department, Centre Hospitalier de Versailles, Le Chesnay, France.
University Paris-Saclay, UVSQ, INSERM, CESP, Team « PsyDev », Villejuif, France.
Dev Med Child Neurol. 2020 Sep;62(9):1017-1023. doi: 10.1111/dmcn.14562. Epub 2020 May 15.
Therapeutic hypothermia is among the adjuvant therapies suggested for refractory or super-refractory status epilepticus (R/SR-SE) in paediatric patients. Experimental evidence of neuroprotective and antiseizure effects provides a strong rationale for using therapeutic hypothermia in patients with status epilepticus. Thus, hypothermia between 20°C and 33°C in animals with status epilepticus is associated not only with significantly less neuronal damage, predominantly in the hippocampal CA1, CA2, and CA3 areas, but also with increased seizure latency and decreased seizure frequency and duration. Therapeutic hypothermia has rarely been used in paediatric R/SR-SE. In the few reported cases, seizure control was markedly improved but nearly half the patients experienced recurrences after rewarming. Studies are needed to clarify the modalities and indications of therapeutic hypothermia in paediatric patients with R/SR-SE. WHAT THIS PAPER ADDS: Hypothermia at 20°C to 33°C is neuroprotective and has antiseizure effects in experimental status epilepticus. In children, antiseizure effects are marked but recurrences after rewarming are common.
亚低温治疗是一种辅助治疗难治性或超难治性癫痫持续状态（R/SR-SE）的方法，适用于儿科患者。实验证据表明，亚低温治疗具有神经保护和抗癫痫作用，为癫痫持续状态患者使用亚低温治疗提供了强有力的理论依据。因此，在癫痫持续状态的动物模型中，亚低温治疗（20°C 至 33°C）不仅与显著减少神经元损伤（主要发生在海马 CA1、CA2 和 CA3 区）有关，还与延长癫痫发作潜伏期、减少癫痫发作频率和持续时间有关。亚低温治疗在儿科 R/SR-SE 中很少使用。在少数报道的病例中，癫痫发作得到明显控制，但近一半的患者在复温后出现复发。需要进一步的研究来阐明亚低温治疗在儿科 R/SR-SE 患者中的方式和适应证。本文的主要贡献：在实验性癫痫持续状态中，亚低温（20°C 至 33°C）具有神经保护和抗癫痫作用。在儿童中，亚低温治疗具有明显的抗癫痫作用，但复温后复发较为常见。
