癫痫持续状态的诊疗进展

癫痫持续状态（SE）是一类发病率、致残率和致死率极高的神经危重症疾病。随着研究的不断深入,人们对SE的机制及持续发作造成的多系统损伤有了进一步的了解,早期发现及快速终止发作成为SE治疗的关键。然而由于缺少可靠的循证医学证据,目前对癫痫持续状态的管理及治疗策略仍存在较大争议。本文通过对近年来文献的回顾,针对癫痫持续状态概念及分类的更新、流行病学、诊断和药物治疗作一综述。     

癫痫持续状态的诊疗进展

癫痫持续状态（SE）是一类发病率、致残率和致死率极高的神经危重症疾病。随着研究的不断深入,人们对SE的机制及持续发作造成的多系统损伤有了进一步的了解,早期发现及快速终止发作成为SE治疗的关键。然而由于缺少可靠的循证医学证据,目前对癫痫持续状态的管理及治疗策略仍存在较大争议。本文通过对近年来文献的回顾,针对癫痫持续状态概念及分类的更新、流行病学、诊断和药物治疗作一综述。     

《癫痫持续状态的诊断和治疗》出版

由王学峰、肖波、洪震教授主编,沈鼎烈教授主审,国内9所大学的13位癫痼病学专家集体撰写的《癫痫持续状态的诊断和治疗》一书已由人民卫生出版社出版发行。该书是国内第一本有关癫痫持续状态诊断与治疗的专著,全书共分10章,77万字。     

鼠药中毒致癫痫持续状态的诊断及治疗

鼠药 (杀鼠剂 )种类很多 ,常见者为敌鼠及其钠盐 ,近年来又大量出现已禁止使用的有机氟制剂和毒性极大的毒鼠强。因临床表现为癫痫持续状态 (SE) ,患者多在神经科首诊。我们收集 1995～ 2 0 0 2年误服、自服、被投毒鼠药中毒总计 6 0例 ,选取 13例重度中毒致SE ,对其临床诊断及治疗等有关问题进行了分析研究 ,现报道如下。1　临床资料1.1　一般资料　本组 13例 ,全部患者均经毒物鉴定。其中氟乙酰胺中毒致SE 5例 ,毒鼠强中毒致SE 8例。男 7例 ,女 6例 ,年龄 7～ 6 0岁 ,平均年龄 32岁。全部均为口服中毒。就诊时间 :6小时内 3例 ,2 4小…     

难治性癫痫持续状态的药物治疗进展

难治性癫痫持续状态(RSE)是指使用常规抗癫痫治疗不能控制的持续癫痫发作超过1h的状态,有效控制癫痫发作是挽救患者生命、改善其预后的关键。此文回顾分析了2003-2005年国内外治疗RSE的有关文献,将其所用药物用法、用量及作用机制做一综述。     

癫痫持续状态的临床研究新进展

癫痫持续状态是临床上常见的急症 ,癫痫病史、抗癫痫药物水平降低、低龄是其最重要的危险因素 ;高热、肺水肿、心律失常是其急性并发症 ;国外推荐劳拉西泮作为首选治疗药物。本文就近年来有关的临床研究进展做一综述     

癫痫持续状态的药物治疗进展

癫痫持续状态是需要紧急处理的临床急症。近10年来,随着新型抗癫痫药物的不断出现和药物剂型的改 进,癫痫持续状态的治疗取得了飞速发展,本文回顾有关文献,介绍了SE的最新治疗进展。     

《癫痫持续状态的诊断和治疗》出版

由王学峰、肖波、洪震教授主编,沈鼎烈教授主审,国内9所大学的13位癫痫病学专家集体撰写的《癫痫持续状态的诊断和治疗》一书已由人民卫生出版社出版发行。该书是国内第一本有关癫痫持续状态诊断与治疗的专著,全书共分10章,77万字。按照国际抗癫痫联盟重建癫痫知识新框架的要求,从全新的角度深入浅出地介绍了有关癫痫持续状态的新定义、病因、分类、发病机制、临床表现、治疗措施、预后及有关流行病学情况,     

《癫痫持续状态的诊断和治疗》出版

由王学峰、肖波、洪震教授主编,沈鼎烈教授主审,国内9所大学的13位癫痫病学专家集体撰写的《癫痫持续状态的诊断和治疗》一书已由人民卫生出版社出版发行。该书是国内第一本有关癫痫持续状态诊断与治疗的专著,全书共分10章,77万字。     

Status Epilepticus and Refractory Status Epilepticus Management

Status epilepticus (SE) describes persistent or recurring seizures without a return to baseline mental status and is a common neurologic emergency. SE can occur in the context of epilepsy or may be symptomatic of a wide range of underlying etiologies. The clinician׳s aim is to rapidly institute care that simultaneously stabilizes the patient medically, identifies and manages any precipitant conditions, and terminates seizures. Seizure management involves “emergent” treatment with benzodiazepines followed by “urgent” therapy with other antiseizure medications. If seizures persist, then refractory SE is diagnosed and management options include additional antiseizure medications or infusions of midazolam or pentobarbital. This article reviews the management of pediatric SE and refractory SE.     

Electroconvulsive Therapy for Refractory Status Epilepticus: A Case Series

Background  

Status epilepticus refractory to conventional anti-epileptic drugs typically has a poor prognosis, but patients may recover well if seizures can be stopped. Case reports suggest that electroconvulsive therapy (ECT) may stop seizures in patients with refractory status epilepticus, and we sought to examine its effectiveness in a series of patients.     

癫痫持续状态的定义演变

癫痫持续状态是神经内科常见的急危重症。对癫痫持续状态概念的界定是进行临床诊疗 和科学研究的基础,随着癫痫持续状态病理生理机制研究的深入,其定义也在不断地修订与完善, 由抽象到具体,由惊厥到非惊厥,癫痫发作持续时间逐渐严谨且更加强调难治性的概念。本文着重 回顾癫痫持续状态的定义演变历程。     

Two Cases of Nonconvulsive Status Epilepticus in Association with Tiagabine Therapy

We report two patients with intractable partial seizures who developed generalized nonconvulsive status epilepticus (NCSE) after receiving tiagabine (TGB). Neither had a history of absence seizures or generalized epileptic discharges on prior EEG monitoring. Clinicians need to be aware of a possible association between TGB and NCSE.     

The EEG and Prognosis in Status Epilepticus

Summary: Purpose: To examine the relation between specific EEG features and clinical outcome, determine whether a predictable sequence of EEG patterns exists during status epilepticus (SE), and examine the relation between periodic epileptiform discharges (PEDs) and SE.
Methods: EEG records of 50 patients with SE admitted to Graduate Hospital between January 1990 and July 1995 were reviewed. Ictal EEGs were available in 72%; 28% had only postictal EEGs. Poor outcome was defined as death or persistent vegetative state, and good outcome as all others. Fisher's Exact test, x², and t tests were performed for data analysis.
Results: Of 50 patients, 72% had a good outcome and 28%, a poor outcome. If PEDs were present at any time during or after SE, outcome tended to be worse (p = 0.053). With PEDs, eight (44%) of 18 had a poor outcome; without PEDs, six (19%) of 32 had a poor outcome. Etiologies for SE did not substantially differ in patients with or without PEDs, and structural abnormalities were not more associated with the presence of PEDs. PEDs were seen both early and late, during and after SE. Other EEG characteristics (lateralized vs. bilateral symmetric ictal EEG, discrete vs. continuous ictal activity, and postictal focal slowing) did not relate to outcome. No predictable sequence of EEG changes was found during SE.
Conclusions: PEDs are the only EEG feature related to outcome in SE and are associated with poor outcome independent of etiology.     

Oculoclonic Status Epilepticus

Continuous oculoclonic status epilepticus occurred for 90 min in a 4-year-old girl. The seizure consisted of continuous contralateral horizontal nystagmus concurrent with left occipital spike discharges, occasional vomiting and no loss of consciousness. Oculoclonic status epilepticus may be a variant form of versive status epilepticus.