癫痫发作和癫痫持续状态的评估和治疗。

Evaluation and Management of Seizures and Status Epilepticus.

机构信息

Department of Neurology, University of Florida McKnight Brain Institute, 1149 Newell Drive, Gainesville, FL 32610, USA; Department of Neurosurgery, University of Florida McKnight Brain Institute, 1149 Newell Drive, Gainesville, FL 32610, USA.

Department of Pharmacy, Yale New Haven Health, 55 Park Street, New Haven, CT 06511, USA.

出版信息

Neurol Clin. 2021 May;39(2):513-544. doi: 10.1016/j.ncl.2021.01.009.

DOI:10.1016/j.ncl.2021.01.009

PMID:33896531

Abstract

Seizures are frequently triggered by an inciting event and result from uninhibited excitation and/or decreased inhibition of a pool of neurons. If physiologic seizure abortive mechanisms fail, the ensuing unrestrained synchronization of neurons-status epilepticus-can be life-threatening and is associated with the potential for marked morbidity in survivors and high medical care costs. Prognosis is intimately related to etiology and its response to therapeutic measures. Timely implementation of pharmacologic therapy while concurrently performing a stepwise workup for etiology are paramount. Neurodiagnostic testing should guide titration of pharmacologic therapies, and help determine if there is a role for immune modulation.

摘要

发作通常由激发事件引发，是由于神经元群不受抑制的兴奋和/或抑制减少所致。如果生理上的癫痫发作中止机制失效，随后神经元不受控制的同步（癫痫持续状态）可能危及生命，并与幸存者发生明显发病率和高医疗费用的风险相关。预后与病因及其对治疗措施的反应密切相关。及时实施药物治疗，同时逐步进行病因检查至关重要。神经诊断测试应指导药物治疗的滴定，并有助于确定免疫调节是否有作用。