Walton N Y
Neurology Service, Department of Veterans Affairs Medical Center, Los Angeles, California.
Epilepsia. 1993;34 Suppl 1:S54-8. doi: 10.1111/j.1528-1157.1993.tb05906.x.
Generalized convulsive status epilepticus (GCSE) is accompanied by a marked increase in plasma catecholamines. This produces a number of changes in general systemic physiology including hypertension, tachycardia, cardiac arrhythmias, hyperglycemia, acidosis, and hyperpyrexia. If SE is stopped quickly, these changes are self-correcting and do not produce an increased risk of neuropathology. However, if seizures continue, many of the early physiologic changes reverse, and late status epilepticus is marked by hypotension, hypoglycemia, pulmonary edema and a continued acidosis and elevation of body temperature. Prevention of serious hypoglycemia, maintenance of adequate systemic blood pressure to provide adequate cerebral perfusion, and normalizing the body temperature will minimize or prevent neuropathologic sequelae to SE of extended duration.
全身性惊厥性癫痫持续状态(GCSE)伴有血浆儿茶酚胺显著升高。这会在全身生理方面产生一系列变化,包括高血压、心动过速、心律失常、高血糖、酸中毒和高热。如果癫痫持续状态迅速停止,这些变化会自行纠正,不会增加神经病理学风险。然而,如果癫痫发作持续,许多早期生理变化会逆转,晚期癫痫持续状态的特征是低血压、低血糖、肺水肿以及持续的酸中毒和体温升高。预防严重低血糖、维持足够的全身血压以提供充足的脑灌注以及使体温正常化,将最大限度地减少或预防长时间癫痫持续状态的神经病理学后遗症。