Martin P J, Millac P A
Department of Neurology, Leicester Royal Infirmary, UK.
Seizure. 1994 Jun;3(2):107-13. doi: 10.1016/s1059-1311(05)80200-6.
Morbidity and mortality from status epilepticus might be reduced by attention to recommended management protocols. We studied our experience of 107 episodes of status epilepticus in 43 patients over a 5-year period. Overall mortality was 2% and permanent sequelae developed in 11 cases (10%). Although hospital admission was rapid, treatment could be initiated more quickly in the community (P < 0.0001). However treatment given before admission did not significantly reduce the duration of status (median difference 38 minutes, 95% C.I., 24 to 55 minutes). Diazepam was the first line treatment in 98 episodes, chlormethiazole and phenytoin were used in 27 and 18 episodes, respectively. Paraldehyde was used in 12 episodes. Midazolam was used in the intensive care setting in two cases. Clonazepam, lorazepam, lignocaine and phenobarbitone were not used at all. There was a marked failure to adhere to the recommended management protocols.
遵循推荐的治疗方案或许能降低癫痫持续状态的发病率和死亡率。我们研究了43例患者在5年期间发生的107次癫痫持续状态的治疗经验。总体死亡率为2%，11例（10%）出现永久性后遗症。尽管患者入院迅速，但在社区能更快开始治疗（P < 0.0001）。然而，入院前的治疗并未显著缩短癫痫持续状态的持续时间（中位数差异38分钟，95%置信区间，24至55分钟）。98次发作中地西泮为一线治疗药物，27次和18次发作分别使用了氯美噻唑和苯妥英。12次发作使用了副醛。2例在重症监护室使用了咪达唑仑。氯硝西泮、劳拉西泮、利多卡因和苯巴比妥根本未使用。在遵循推荐的治疗方案方面存在明显不足。
