癫痫持续状态

最后审阅: 28 四月 2022
最后更新: 13 七月 2020

小结

定义

病史和体格检查

关键诊断因素

  • 长时间或反复强直阵挛性发作伴意识水平改变(惊厥性 SE)
  • 意识水平改变、意识模糊或人格改变,伴运动表现有限或缺失(非惊厥性 SE)
  • 危险因素
完整详情

危险因素

  • 抗惊厥治疗依从性差
  • 酒精使用障碍
  • 卒中
  • 毒性或代谢性病因
  • 难治性癫痫
  • 进程导致直接皮质结构损伤
  • 使用娱乐性药物
完整详情

诊断性检查

首要检查

  • 葡萄糖
  • 动脉血气分析
  • 尿素
  • 肌酐
  • 肝功能检测
  • 钠、钙和镁水平
  • 全血细胞计数
  • C 反应蛋白
  • 凝血筛查
  • 抗惊厥药物水平
完整详情

需考虑的检查

  • 胸部 X 线检查
  • 头颅 CT
  • 腰椎穿刺
  • 毒理学筛查
完整详情

治疗流程

急症处理

惊厥性癫痫持续状态:在医院中

惊厥性癫痫持续状态:在社区情境中

非惊厥性癫痫持续状态

撰稿人

专家顾问

Matthew Jones, MD, FRCP

Consultant Neurologist

Greater Manchester Neurosciences Centre

Salford Royal Foundation Trust

UK

简介

MJ is an honorary senior lecturer at the University of Manchester.

利益声明

MJ declares that he has no competing interests.

Rachael Power, MBChB, MRCP

Neurology Registrar

Manchester Centre for Clinical Neurosciences

Salford Royal NHS Foundation Trust

UK

利益声明

RP has been sponsored by Novartis to attend the International Headache Conference.

鸣谢

BMJ Best Practice would like to gratefully acknowledge the previous team of expert contributors, whose work is retained in parts of the content:

Ronald P. Lesser, MD

Professor of Neurology and Neurosurgery

Johns Hopkins Medical Institutions

Baltimore

MD

Disclosures: RPL's wife holds shares in Abbott Laboratories, which makes Depakote, a brand formulation of valproate/divalproex. RPL holds shares in Abbvie, Express Scripts, Halgene, Halyard Health, Hospira, Johnson and Johnson (which makes Topamax, a brand formulation of topiramate), Merck and Company, and Pfizer (which makes Dilantin and Cerebyx, brand formulations of phenytoin and fosphenytoin, respectively).

Emily Johnson, MD

Assistant Professor of Neurology

Johns Hopkins Medical Institutions

Baltimore

MD

Disclosures: EJ declares that she has no competing interests.

同行评议者

Hannah Cock, MD, FRCP

Professor of Epilepsy and Medical Education

Consultant Neurologist

St George's University Hospitals NHS Foundation Trust

London

UK

利益声明

HC has received personal fees from Sage Pharmaceuticals Ltd, Eisai Europe Ltd, UCB Pharma Ltd, the European Medicines Agency, the UK Epilepsy Nurse Specialist Association, Bial, and Eisai. She has received non-financial support from Special Products Ltd, the European Academy of Neurology, and the International League Against Epilepsy E-learning Task Force. She has received grants from the US NIH Institute of Neurological Disorders and Stroke. HC also reports other conflicting interests related to Novartis and GW Research Ltd. HC is an author of a number of references cited in this topic.

编辑

Helena Delgado-Cohen,

Section Editor, BMJ Best Practice

利益声明

HDC declares that she has no competing interests.

Sue Mayor,

Lead Section Editor, BMJ Best Practice

利益声明

SM works as a freelance medical journalist and editor, video editorial director and presenter, and communications trainer. In this capacity, she has been paid, and continues to be paid, by a wide range of organisations for providing these skills on a professional basis. These include: NHS organisations, including NICE, NHS Choices, NHS Kidney Care, and others; publishers and medical education companies, including the BMJ Group, the Lancet group, Medscape, and others; professional organisations, including the British Thoracic Oncology Group, the European Society for Medical Oncology, NCEPOD, and others; charities and patients’ organisations, including the Roy Castle Lung Cancer Foundation and others; pharmaceutical companies, including Bayer, Boehringer Ingelheim, Novartis, and others; and communications agencies, including Publicis, Red Healthcare, and others. She has no stock options or shares in any pharmaceutical or healthcare companies; however, she invests in a personal pension, which may invest in these types of companies. She is managing director of Susan Mayor Limited, the company name under which she provides medical writing and communications services.

Tannaz Aliabadi-Oglesby,

Lead Section Editor, BMJ Best Practice

利益声明

TAO declares that she has no competing interests.

Julie Costello,

Comorbidities Editor, BMJ Best Practice

利益声明

JC declares that she has no competing interests.

Adam Mitchell,

Drug Editor, BMJ Best Practice

利益声明

AM declares that he has no competing interests.

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