Oliveros Juste A
Servicio de Neurología, Hospital Miguel Servet, Zaragoza.
Neurologia. 1997 Dec;12 Suppl 6:74-81.
Status epilepticus (SE), an special epileptic syndrome, is a frequent neurological emergency (50/100,000) and a critical condition (mean mortality 22%, in 3% of pediatric patients and 38% in the elderly). Accepting its widest concept, it appears without history of epilepsy in 58%. Neuronal damage, mainly hypocampal, has been experimentally demonstrated in convulsive and nonconvulsive SE. We attempt to demonstrate that the most important prognostic factors are: age, more related to morbidity in children and in mortality in the elderly; etiology, determining the evolution in most cases, but not always: in the same etiological group, the coincidence of SE can increase threefold the mortality; the seizure type, especially the convulsive SE; patients with previous epilepsy have a better outcome; the epileptic syndrome, rather determinant of incidence and outcome of the SE in the childhood; the length of SE, but in the cases of outcome directly depending on the etiology; the evolutive phase in which treatment is started; the complications, mainly respiratory; the global therapeutical strategy and the adequate use of drugs, related to order, dosage and timing, are determinant of morbidity and mortality.
癫痫持续状态（SE）是一种特殊的癫痫综合征，是常见的神经科急症（发病率为50/100,000），也是一种危急病症（平均死亡率为22%，在儿科患者中为3%，在老年患者中为38%）。从最宽泛的概念来看，58%的癫痫持续状态患者既往无癫痫病史。在惊厥性和非惊厥性癫痫持续状态中，均已通过实验证实存在神经元损伤，主要是海马区的损伤。我们试图证明，最重要的预后因素包括：年龄，在儿童中更多与发病率相关，在老年人中与死亡率相关；病因，在大多数情况下决定病情发展，但并非总是如此：在同一病因组中，癫痫持续状态的并发可使死亡率增加两倍；发作类型，尤其是惊厥性癫痫持续状态；既往有癫痫病史的患者预后较好；癫痫综合征，在很大程度上决定儿童癫痫持续状态的发病率和预后；癫痫持续状态的持续时间，但在预后直接取决于病因的情况下除外；开始治疗时的疾病进展阶段；并发症，主要是呼吸系统并发症；整体治疗策略以及药物的合理使用，与用药顺序、剂量和时机有关，是发病率和死亡率的决定因素。
