难治性癫痫持续状态的预后及处理.pptxVIP

难治性癫痫持续状态的预后及处理第1页/共23页 诊 断 二种以上药物治疗维持一小时以上，未能有效控制。第2页/共23页 *Jan Novy, yGiancarlo Logroscino, Refractory status epilepticus: A prospective observational study。 Epilepsia, 2010，51(2):251–256Status epilepticus (SE) that is resistant to two antiepileptic compounds is defined as refractory status epilepticus (RSE). In the few available retrospective studies, estimated RSE frequency is between 31% and 43% of patients presenting an SE episode; almost all seem to require a coma induction for treatment. We prospectively assessed RSE frequency, clinical predictors, and outcome in a tertiary clinical setting. 第3页/共23页 *Jan Novy, yGiancarlo Logroscino, Refractory status epilepticus: A prospective observational study。 Epilepsia, 2010，51(2):251–256Twenty-nine of 128 SE episodes (22.6%) were refractory to first- and second-line antiepileptic treatments. Severity of consciousness impairment and de novo episodes were independent predictors of RSE. RSE showed a worse outcome than non-RSE (39% vs. 11% for mortality; 21% vs. 63% for return to baseline clinical conditions). Only 12 patients with RSE (41%) required coma induction for treatment. 第4页/共23页 非惊厥性癫痫持续状态（NCSE）长程视频脑电可明显提高诊断率和监测治疗效果第5页/共23页 Eric J. Ericson, Elizabeth E. Gerard，Aphasic status epilepticus: Electroclinical correlation，Epilepsia, 52(8):1452–1458, 2011 All nine patients were right-handed with subacute or chronic left hemispheric lesions on magnetic resonance imaging (MRI). All patients had mixed aphasia, three presenting with persistent aphasia from onset and six with episodic speech impairment, which became persistent in five of the six. The initial 30-min EEG demonstrated electrographic seizure in only five patients (56%), despite the presence of aphasia during the recording. Left hemispheric periodic lateralized epileptiform discharges (PLEDS) were seen in two patients, and left hemispheric slowing in two patients.第6页/共23页 Eric J. Ericson, Elizabeth E. Gerard，Aphasic status epilepticus: Electroclinical correlatio