Epilepsy Program Specialist, Comprehensive Epilepsy Center, Nicklaus Children's Hospital, Miami, FL.
Clinical Research Nurse, Department of Neurology, Virginia Commonwealth University, Richmond, VA.
NASN Sch Nurse. 2021 Nov;36(6):346-354. doi: 10.1177/1942602X211026333. Epub 2021 Jun 30.
Approximately 470,000 children and adolescents in the United States have epilepsy, 30% of whom experience seizures despite antiseizure drug regimens. School nurses, teachers, caregivers, and parents play integral roles in implementing a care plan that avoids triggers, recognizes signs, and provides supportive care-ideally, guided by a patient-specific seizure action plan, which may include the use of rescue medication. Benzodiazepines are the mainstay of seizure rescue medication; for decades, rectally administered diazepam was the only approved rescue medication for seizure clusters outside the hospital setting. However, rectal administration has limitations that could delay treatment (e.g., social acceptability, removal of clothing, positioning). More recently, intranasal midazolam (for patients ≥12 years) and intranasal diazepam (for patients ≥6 years) were approved for this indication. Training and education regarding newer forms of rescue medication should improve confidence in the ability to treat seizures in school with the goal of increasing the safety of students with epilepsy.
美国约有 47 万名儿童和青少年患有癫痫，其中 30%的患者尽管接受了抗癫痫药物治疗，但仍会发作。学校护士、教师、护理人员和家长在实施避免诱因、识别症状和提供支持性护理的护理计划方面发挥着重要作用——最好能在针对患者个体的癫痫发作行动计划的指导下进行，该计划可能包括使用急救药物。苯二氮䓬类药物是癫痫急救药物的主要药物；几十年来，直肠给予的地西泮一直是医院外癫痫发作群的唯一批准的急救药物。然而，直肠给药存在一些限制，可能会延迟治疗（例如，社会接受度、脱衣、定位）。最近，鼻内咪达唑仑（适用于≥12 岁的患者）和鼻内地西泮（适用于≥6 岁的患者）被批准用于该适应症。关于新型急救药物的培训和教育应提高在学校治疗癫痫发作的能力的信心，目的是提高癫痫学生的安全性。
