Haider Hiba A
Department of Neurology, The University of Chicago, 5841 South Maryland Avenue, MC 2030, Chicago, IL 60637, USA.
Med Clin North Am. 2025 Mar;109(2):497-508. doi: 10.1016/j.mcna.2024.10.002. Epub 2024 Nov 16.
Status epilepticus is a time-sensitive neuro-emergency, linked to poor functional outcomes and higher mortality rates. Prompt diagnosis and treatment are crucial to reduce its morbidity and mortality. Status epilepticus is often underdiagnosed in acutely ill hospitalized patients with altered consciousness, in whom most ongoing seizures can be subtle or nonconvulsive. For unexplained, persistent altered consciousness, clinicians should use electroencephalography to confirm or exclude a diagnosis of status epilepticus. A standardized treatment protocol should include prompt and adequately dosed first benzodiazepines as line therapy. Treatment approaches for second-line and third-line management continue to evolve as new anti-seizure medications become available.
癫痫持续状态是一种时间紧迫的神经急症，与功能预后不良和较高死亡率相关。及时诊断和治疗对于降低其发病率和死亡率至关重要。在意识改变的急性病住院患者中，癫痫持续状态常常被漏诊，这些患者中的大多数持续性癫痫发作可能很轻微或为非惊厥性。对于原因不明的持续性意识改变，临床医生应使用脑电图来确诊或排除癫痫持续状态。标准化治疗方案应包括迅速给予足量的一线苯二氮䓬类药物进行治疗。随着新型抗癫痫药物的出现，二线和三线治疗方法也在不断发展。
