昏迷患者非惊厥性癫痫持续状态的临床特点.pdfVIP

.228. J Clin Neurol ,June 2013 ,Vol. 26 ,No. 3 ·学术交流· 昏迷患者非惊厥性癫瘸持续状态的临床特点 中浩，常亮，管军，周晖 [摘要] 目的 探讨昏迷患者非惊厥性癫痛持续状态(NCSE) 的临床特点。方法 回顾性分析6 例昏 迷 NCSE 患者的临床资料。结果 6 例患者中 l 例病毒性脑炎，1 例大面积脑梗死，2 例脑外伤，1 例心肺复苏 术后缺血缺氧性脑病，1 例肾移植后代谢性脑病。其中，2 例出现躁动，1 例摇头、嘴唇咂动，2 例四肢微小抽 动， 1 例颜面抽动。所有患者的持续 EEG(CEEG) 监测均出现广泛或者局灶并发广泛的异常放电。结论 昏 迷患者发生NCSE 时多表现为躁动或面部、四肢微小抽动，CEEG 监测能发现异常放电，有助于指导临床诊治。 [关键词] 昏迷;非惊厥d性癫痛持续状态;持续 EEG [中圄分类号] R742. 1 [文献标识码] A [文章编号] 1004-1648 (2013 )03 -0228 -03 Clinical features of nonconvulsive status epilepticus in comatose patients SHEN Hα， 0 ， CHANG Liang , GUAN Jun , et al. Department 0/ Neurology , Changzheng Hospital A庐liated to Second Militαry Medical University , Shanghαi 200003 , China Abstract: Objective To explore the clinical features of nonconvulsive status epilepticus (NCSE) in comatose patients. Methods The clinical data of 6 comatose patients with NCSE were analyzed retrospectively. Results There were 1 case of viral encephalitis , 1 case of massive cerebral ischemic infarction , 2 cases of brain trauma , 1 case of hypoxic ischemic encephalopathy after cardiopulmonary resuscitation and 1 case of metabolic encephalopathy after renal transplantation in the 6 comatose patients. In which , there were 2 cases appeared restless , 1 case developed shaking head and smacking her lips , 2 cases showed tiny lwitch of limbs , 1 case had facial twitch. The continuous EEG (CEEG) of all the patients showed wide or reversible focal complicated with wide abnormal discharges. Conclusions NCSE onset in comatose patients often manifeste the restless , tiny lwitch of facial and limbs. CEEG monitoring can detect epileptic discharge and help diagnosis , guide therapy. Key words: comatose; nonconvulsive status epi