恙虫病导致的长时间昏迷：需考虑非惊厥性癫痫持续状态。
Prolonged coma in scrub typhus: consider non-convulsive status epilepticus.
机构信息
Department of Neurology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Raebareli Road, Lucknow, Uttar Pradesh-226014, India.
Currently working in Department of Neurology, Institute of Medical Sciences, Banaras Hindu University, Uttar Pradesh-221005, India.
出版信息
Trans R Soc Trop Med Hyg. 2021 Sep 3;115(9):1091-1093. doi: 10.1093/trstmh/trab007.
BACKGROUND
Scrub typhus is prevalent in the Tsutsugamushi belt and may manifest with meningoencephalitis and seizures. We report a patient with scrub typhus who had non-convulsive status epilepticus (NCSE).
METHODS
A 50-y-old female with fever and altered sensorium for 5 d was diagnosed as scrub typhus based on serum IgM ELISA. She was on mechanical ventilation and received doxycycline and ceftriaxone, but did not improve until the third day of admission.
RESULTS
An EEG revealed >2.5 Hz generalised epileptiform discharges, which were suppressed by intravenous lorazepam suggesting NCSE. Following valproate and levetiracetam, she became conscious and had a full recovery.
CONCLUSION
A scrub typhus patient recovers even after prolonged NCSE.
背景
恙虫病流行于恙螨带，可能表现为脑膜脑炎和癫痫发作。我们报告了一例恙虫病患者，其表现为非惊厥性癫痫持续状态（NCSE）。
方法
一名 50 岁女性，发热伴意识改变 5 天，基于血清 IgM ELISA 诊断为恙虫病。她接受机械通气，并接受强力霉素和头孢曲松治疗，但直到入院第 3 天才有所改善。
结果
脑电图显示 >2.5 Hz 弥漫性癫痫样放电，静脉注射劳拉西泮后被抑制，提示为 NCSE。给予丙戊酸钠和左乙拉西坦后，她恢复意识并完全康复。
结论
即使在长时间的 NCSE 后，恙虫病患者也能恢复。
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