Hauser W A
Adv Neurol. 1983;34:3-14.
Status epilepticus is associated with high mortality and is a predictor of poor neurological outcome; yet the contribution of prolonged seizures to mortality and the causal sequence for neurological damage remain unclear. Many cases of status epilepticus are precipitated by illnesses that themselves are associated with increased mortality and morbidity. In studies of children, status epilepticus appears to be no better a predictor of an adverse outcome than is any seizure disorder starting at a similar age. Status epilepticus is a condition in which fast and definitive medical intervention is warranted. Random assignment to treatment groups is difficult. Evaluation of the effect of duration of seizures is also difficult, because those patients responding promptly to treatment may be quite a different population than those not responding. The study of cases of "nonconvulsive" status may provide information regarding the effect of these continuing ictal brain discharges, which can be evaluated without the confounding effects of concomitant metabolic (e.g., anoxic, pH, electrolyte) disturbances that accompany most cases of generalized status epilepticus. It is possible that appropriately designed prospective studies of status epilepticus and/or case-control studies will assist in evaluating the contribution of a prolonged seizure per se over and above that associated with preexisting or concurrent illness.
癫痫持续状态与高死亡率相关，是神经功能预后不良的一个预测指标；然而，长时间癫痫发作对死亡率的影响以及神经损伤的因果顺序仍不明确。许多癫痫持续状态病例是由本身就与死亡率和发病率增加相关的疾病所诱发的。在儿童研究中，癫痫持续状态似乎并不比任何在相似年龄开始发作的癫痫障碍更能预测不良预后。癫痫持续状态是一种需要迅速进行明确医学干预的情况。随机分配到治疗组很困难。评估癫痫发作持续时间的影响也很困难，因为那些对治疗迅速做出反应的患者可能与没有反应的患者群体截然不同。对“非惊厥性”癫痫持续状态病例的研究可能会提供有关这些持续性痫性脑放电影响的信息，这种影响可以在不受到大多数全身性癫痫持续状态病例伴随的代谢（如缺氧、酸碱度、电解质）紊乱混杂效应影响的情况下进行评估。有可能设计得当的癫痫持续状态前瞻性研究和/或病例对照研究将有助于评估长时间癫痫发作本身相较于与既有疾病或并发疾病相关的影响之外的作用。
