Celesia G G, Grigg M M, Ross E
Stritch School of Medicine, Department of Neurology, Loyola University of Chicago, Maywood, IL 60153.
Arch Neurol. 1988 Jul;45(7):781-4. doi: 10.1001/archneur.1988.00520310099023.
Nineteen cases of generalized status myoclonicus (GSM) associated with acute anoxic and/or toxic-metabolic encephalopathy were studied. Generalized status myoclonicus was associated with coma in the overwhelming majority of patients (95%), although one patient had only clouding of consciousness. Generalized status myoclonicus occurred in 13 patients after cardiorespiratory arrest and in six patients after toxic-metabolic encephalopathy. Thirteen patients died, four survived in a chronic vegetative state, and two recovered without any permanent neurologic sequelae. Generalized status myoclonicus was preceded by generalized tonic-clonic seizures or generalized tonic-clonic status epilepticus in six patients (32%). The implications of these findings are discussed and a hypothesis that generalized status myoclonicus is a fragment of generalized tonic-clonic status epilepticus is proposed. Generalized status myoclonicus is a grave prognostic indicator that is often not compatible with useful recovery in spite of all therapeutic efforts. The final outcome is related to the underlying disease process. In our study, complete neurologic recovery was observed in two patients (11%).
对19例与急性缺氧和/或中毒代谢性脑病相关的全身性肌阵挛持续状态（GSM）患者进行了研究。绝大多数患者（95%）的全身性肌阵挛持续状态与昏迷相关，尽管有1例患者仅有意识模糊。13例患者在心肺骤停后出现全身性肌阵挛持续状态，6例患者在中毒代谢性脑病后出现。13例患者死亡，4例存活于慢性植物状态，2例康复且无任何永久性神经后遗症。6例患者（32%）在全身性肌阵挛持续状态之前出现全身性强直阵挛发作或全身性强直阵挛癫痫持续状态。讨论了这些发现的意义，并提出了一个假说，即全身性肌阵挛持续状态是全身性强直阵挛癫痫持续状态的一个片段。全身性肌阵挛持续状态是一个严重的预后指标，尽管进行了所有治疗努力，通常仍与良好恢复不相符。最终结局与潜在的疾病过程有关。在我们的研究中，2例患者（11%）实现了完全神经恢复。
