Faculty of Medicine, University of Bergen, Bergen, Norway.
Department of Clinical Neurophysiology, Haukeland University Hospital, Bergen, Norway.
Seizure. 2024 Aug;120:116-123. doi: 10.1016/j.seizure.2024.06.023. Epub 2024 Jun 24.
Refractory (RSE) and super-refractory status epilepticus (SRSE) are serious medical emergencies whose long-term outcomes depend on the timeliness of their management. Population-based clinical and epidemiological data on these conditions are sparse. We aimed to provide a detailed description of the epidemiology and clinical course of RSE and SRSE in children and adolescents and identify potential prognostic biomarkers.
In this retrospective population-based study, patients aged one month to 18 years who fulfilled the RSE/SRSE diagnostic criteria and were admitted to the intensive care unit of Haukeland University Hospital from 2012 to 2021 were considered eligible. Detailed clinical and laboratory findings along with information on management and outcomes were systematically analyzed.
Forty-three patients with 52 episodes of RSE/SRSE were identified. The incidence rate was 3.13 per 100,000 per year. The median time from SE onset to the administration of the first rescue drug was 13 min, and from the first rescue drug to second- and third-line treatments, 83 and 66 min, respectively. All patients were alive at discharge.
Delays in treatment were observed in various stages of the clinical course of RSE/SRSE. Improvement measures targeting the prompt administration of recuse mediation and subsequent treatment escalation are needed.
难治性癫痫持续状态（RSE）和超难治性癫痫持续状态（SRSE）是严重的医疗紧急情况，其长期预后取决于管理的及时性。关于这些情况的基于人群的临床和流行病学数据很少。我们旨在详细描述儿童和青少年 RSE 和 SRSE 的流行病学和临床过程，并确定潜在的预后生物标志物。
在这项回顾性基于人群的研究中，符合 RSE/SRSE 诊断标准并于 2012 年至 2021 年期间入住豪克兰大学医院重症监护病房的年龄在 1 个月至 18 岁的患者被认为符合入选条件。系统分析了详细的临床和实验室发现以及管理和结果信息。
共确定了 43 例 52 例 RSE/SRSE 患者。发病率为每年每 100,000 人 3.13 例。从 SE 发作到首次抢救药物的中位时间为 13 分钟，从首次抢救药物到二线和三线治疗的时间分别为 83 分钟和 66 分钟。所有患者在出院时均存活。
在 RSE/SRSE 的临床过程的各个阶段都观察到了治疗延迟。需要采取措施，以确保抢救药物的及时给药和随后的治疗升级。
