Harrison A M, Lugo R A, Schunk J E
Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, USA.
Pediatr Emerg Care. 1997 Dec;13(6):420-2. doi: 10.1097/00006565-199712000-00019.
Convulsive status epilepticus (CSE) refractory to treatment with benzodiazepines, phenobarbital, and phenytoin presents a challenge to pediatric emergency and critical care specialists. Prompt seizure control may prevent mortality and morbidity.
A nine-month-old girl with hereditary fructose intolerance had prolonged, refractory CSE. Her seizures promptly stopped after administration of propofol (3 mg/kg bolus followed by infusion of 100 micrograms/kg/min). This dose resulted in electroencephalographic burst suppression. She required endotracheal intubation, invasive hemodynamic monitoring, and pressor support.
This is the first pediatric case of prolonged, refractory CSE treated with propofol. The adult experience is reviewed. Propofol should be used only in a setting where definitive airway control and hemodynamic support is possible.
对苯二氮䓬类、苯巴比妥和苯妥英治疗无效的惊厥性癫痫持续状态（CSE）给儿科急诊和重症监护专家带来了挑战。迅速控制癫痫发作可预防死亡和发病。
一名患有遗传性果糖不耐受的9个月大女孩出现了持续时间长且难治的CSE。在给予丙泊酚（3毫克/千克推注，随后以100微克/千克/分钟的速度输注）后，她的癫痫发作迅速停止。该剂量导致脑电图爆发抑制。她需要气管插管、有创血流动力学监测和升压支持。
这是第一例用丙泊酚治疗的持续时间长且难治的CSE儿科病例。回顾了成人的经验。丙泊酚仅应在能够进行确定性气道控制和血流动力学支持的情况下使用。
