儿童癫痫持续状态的研究进展

癫痫持续状态(status epilepticus,SE)是一种在儿科常见的威胁生命的神经系统急症,如不及时控制,常导致脑及多器官缺氧缺血性损害,造成继发性永久性脑损伤甚至死亡.积极、迅速、有效控制癫痫发作是挽救患者生命、改善其预后的关键,在儿科领域尤为重要.SE目前最被认可的定义为:每次癫痫发作持续5min以上,或2次以上发作,发作间期神经系统功能未恢复至正常基线.2015年国际抗癫痫联盟(international league against epilepsy,ILAE)更新了SE最新定义,重新确定了各发作类型符合SE诊断及持续发作造成损伤的发作时间,使临床治疗更积极主动,减少合并症及后遗症的产生.该文从目前国内外的研究现状出发,总结了儿童SE的定义及更新、病因、分类、治疗、处置及预后,同时回顾最近几年国内外相关文献,为临床早期识别诊断和临床规范治疗儿童SE提供参考.

Progress in research of status epilepticus in children

Status epilepticus (SE) is one of the most common neurologic emergencies and can be associated with significant morbidity and mortality if not treated promptly and aggressively.Actively,quickly and effectively controlling seizures is the key to save patient's life and improve the prognosis,which is particularly important in children.The status epilepticus is currently most recognized as:a single epileptic seizure lasting for more than 5 minutes during each seizure,or more than 2 episodes,with interictal neurological function that can not return to normal baseline.In 2015,ILAE updated the new definition of SE,which redefined the time of onset to diagnose SE and also redefined the time of onset to cause damage to brain.The new definition made clinical treatment more active and positive,and reduced the incidence of complications and sequelae.The purpose of this article is to summarize the definition,etiology,classification,physiopathologic mechanism,treatment and prognosis of SE.Also we review the published reports to provide the reference for early clinical diagnosis and standard treatment of SE.