Treatment strategy of refractory status epilepticus
10.3760/cma.j.issn.2095-428X.2015.18.004
- VernacularTitle:难治性痉挛性癫持续状态的治疗对策
- Author:
Sida YANG
- Publication Type:Journal Article
- Keywords:
Epilepticus;
Refractory/super-refractory;
Treatment strategy
- From:
Chinese Journal of Applied Clinical Pediatrics
2015;(18):1371-1378
- CountryChina
- Language:Chinese
-
Abstract:
Status epilepticus basis for sustained duration and response to treatment can be divided into early status epilepticus,established status epilepticus,refractory status epilepticus and super-refractory status epilepticus. This article reviews the treatment approaches. Mainly conducted a systematic review for treatment strategy of refractory status epilepticus and super-refractory status epilepticus. Including pathogenic factors and cerebral damage analysis. It proposed super-refractory status epilepticus is an uncommon but important clinical problem with high mortality and morbidity rates. The published world literature on the following treatments is critically evaluated:anaesthetic a-gents,anti-epileptic drugs,magnesium infusion,pyridoxine,steroids and immunotherapy,ketogenic diet,hypothermia,e-mergency resective neurosurgery and multiple subpial transection,transcranial magnetic stimulation,vagal nerve stimula-tion,deep brain stimulation,electroconvulsive therapy,drainage of the cerebrospinal fluid and other older drug thera-pies. The importance of treating the identifying cause is stressed. And recommend protocols take a staged approach to treatment. A protocols and flowcharts for managing refractory status epilepticus and super-refractory status epilepticus are suggested.
