Cantón L S, Estrada R, Roselló H, Beguería R
Neurol Neurocir Psiquiatr. 1977;18(2-3 Suppl):325-37.
We have analyzed 105 cases of Status Epilepticus of variable etiology, cared for over a period of 3 years at the "Instituto de Neurología y Neurocirugía". Age, sex, origin, duration of illness before attending the Institute, Conscience variations, clinical crisis types, condition of Status Epilepticus appearance and unleashing factors were considered. Various complementary investigations were performed, although dissimilar in each case. Follow up EEG's were realized in 60% of the patients and pretherapeutic EEG's were done in less than 50%. The necessary time to control the Status was explained, depending on its duration before commencing treatment. Of 93 surviving patients, it was possible to learn the cause of epilepsy only in 43. The necroscopy study of 12 cases demonstrated that death in 9 patients was inevitable for various causes (tumorous, infectious, vascular, etc.) almost always intricate. In other 3 autopsied patients, only signs of cerebral hypoxia and non-neurologic infectious complications were found. In the discussion, the hypoxia-edema-hypoxia mechanism is insisted upon, as well as the need of breaking this circle as an important part of the treatment of these patients.
我们分析了105例病因各异的癫痫持续状态病例,这些病例是在“神经病学与神经外科学研究所”历时3年护理的。考虑了年龄、性别、来源、到该研究所就诊前的病程、意识变化、临床发作类型、癫痫持续状态出现的情况及诱发因素。进行了各种辅助检查,尽管每个病例的检查各不相同。60%的患者进行了随访脑电图检查,不到50%的患者进行了治疗前脑电图检查。根据治疗前癫痫持续状态的持续时间,解释了控制该状态所需的时间。在93名存活患者中,仅43名患者的癫痫病因得以明确。对12例病例的尸检研究表明,9例患者因各种原因(肿瘤、感染、血管等)几乎总是复杂的情况而不可避免地死亡。在另外3例接受尸检的患者中,仅发现脑缺氧和非神经系统感染并发症的迹象。在讨论中,强调了缺氧-水肿-缺氧机制,以及打破这一循环作为这些患者治疗重要组成部分的必要性。