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癫痫持续状态的抗癫痫药物治疗

Antiepileptic Drug Therapy for Status Epilepticus.

作者信息

Kim Daeyoung, Kim Jae Moon, Cho Yong Won, Yang Kwang Ik, Kim Dong Wook, Lee Soon Tae, No Young Joo, Seo Jong Geun, Byun Jung Ick, Kang Kyung Wook, Kim Keun Tae

机构信息

Department of Neurology, Chungnam National University Hospital, Chungnam National University College of Medicine, Daejeon, Korea.

Department of Neurology, Keimyung University School of Medicine, Daegu, Korea.

出版信息

J Clin Neurol. 2021 Jan;17(1):11-19. doi: 10.3988/jcn.2021.17.1.11.

DOI:10.3988/jcn.2021.17.1.11
PMID:33480193
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7840311/
Abstract

Status epilepticus (SE) is one of the most serious neurologic emergencies. SE is a condition that encompasses a broad range of semiologic subtypes and heterogeneous etiologies. The treatment of SE primarily involves the management of the underlying etiology and the use of antiepileptic drug therapy to rapidly terminate seizure activities. The Drug Committee of the Korean Epilepsy Society performed a review of existing guidelines and literature with the aim of providing practical recommendations for antiepileptic drug therapy. This article is one of a series of review articles by the Drug Committee and it summarizes staged antiepileptic drug therapy for SE. While evidence of good quality supports the use of benzodiazepines as the first-line treatment of SE, such evidence informing the administration of second- or third-line treatments is lacking; hence, the recommendations presented herein concerning the treatment of established and refractory SE are based on case series and expert opinions. The choice of antiepileptic drugs in each stage should consider the characteristics and circumstances of each patient, as well as their estimated benefit and risk to them. In tandem with the antiepileptic drug therapy, careful searching for and treatment of the underlying etiology are required.

摘要

癫痫持续状态(SE)是最严重的神经系统急症之一。SE是一种涵盖广泛的症状学亚型和异质性病因的病症。SE的治疗主要涉及对潜在病因的管理以及使用抗癫痫药物疗法迅速终止癫痫发作活动。韩国癫痫学会药物委员会对现有指南和文献进行了回顾,旨在为抗癫痫药物治疗提供实用建议。本文是该药物委员会系列综述文章之一,总结了SE的分阶段抗癫痫药物治疗。虽然高质量证据支持使用苯二氮䓬类药物作为SE的一线治疗,但缺乏关于二线或三线治疗给药的此类证据;因此,本文中关于已确立的和难治性SE治疗的建议基于病例系列和专家意见。每个阶段抗癫痫药物的选择应考虑每个患者的特征和情况,以及对他们估计的益处和风险。在进行抗癫痫药物治疗的同时,需要仔细查找并治疗潜在病因。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f8ba/7840311/57cadb096b9d/jcn-17-11-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f8ba/7840311/ff1e9de6e239/jcn-17-11-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f8ba/7840311/57cadb096b9d/jcn-17-11-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f8ba/7840311/ff1e9de6e239/jcn-17-11-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f8ba/7840311/57cadb096b9d/jcn-17-11-g002.jpg

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本文引用的文献

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N Engl J Med. 2019 Nov 28;381(22):2103-2113. doi: 10.1056/NEJMoa1905795.
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Management of status epilepticus in adults. Position paper of the Italian League against Epilepsy.成人癫痫持续状态的管理。意大利抗癫痫联盟立场文件。
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Intravenous antiepileptic drugs in adults with benzodiazepine-resistant convulsive status epilepticus: A systematic review and network meta-analysis.
抗癫痫药物的黑框警告:盒子里装的是什么?
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A Comparison of Epileptogenic Effect of Status Epilepticus Treated With Diazepam, Midazolam, and Pentobarbital in the Mouse Pilocarpine Model of Epilepsy.地西泮、咪达唑仑和戊巴比妥治疗癫痫持续状态在小鼠匹鲁卡品癫痫模型中致痫作用的比较
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