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題名 | 癲癇持續狀態的處理=Management of Status Epilepticus |
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作者姓名(中文) | 姚俊興; | 書刊名 | 中華民國重症醫學雜誌 |
卷期 | 3:2 2001.04[民90.04] |
頁次 | 頁166-173 |
分類號 | 415.932 |
關鍵詞 | 癲癇; 癲癇持續狀態; 癲癇重積性發作; Epilepsy; Seizures; Status epilepticus; |
語文 | 中文(Chinese) |
中文摘要 | 所謂「癲癇持續狀態」就是持續性癲癇發作,以前的定義為「一次癲癇發作持續達30分鐘者」或「癲癇反複發作長達30分鐘,兩次發作之間,神經系統功能未能完全回復者」(WHO 1973; ILAE 1981; EFA 1993)。後來因應醫療上實際需要,定義性有修改,包括:一、簡單部分發作、複雜部分發作或失神發作,持續或反初發作達30分鐘者;二、持續全身抽搐性發作長達5分鐘者;或三、一小時內有三次或以上之全身抽搐性發作者(Treiman 1994)。癲癇持續狀態是因為腦部缺乏一些自我保護、終止癲癇發作的生理反應,是一種病理狀態,可能會造成神經系統或身體的嚴重損害,甚至危及性命。治癲癇持續狀態的原則包括:(一)儘快終止癲癇持續狀態;(二)處理可能引起癲癇持續狀態之原因;(三)預防再次發生癲癇持續狀態;以及(四)治療癲癇持續狀態所產生的併發症。癲癇持續狀態一般的死亡率為15-20%,如持續四小時,死亡率上升至50%;如持續超過十二小時,死亡率更高達80%,所以應該視為緊急狀況,積極處理。 |
英文摘要 | Status epilepticus (SE) is defined as “more than 30 minutes of continuous seizure activity or two or more sequential seizures without full recovery of consciousness between seizures” (Who 1973; ILAE 1981; EFA 1993). The definition has later been modified as: (1) minutes of continuous seizures or lack of recovery between discrete seizure for focal, complex partial, absence and other form of convulsive seizures; (2) 5 minutes of continuous generalized convulsive seizures; or (3) three or more discrete generalized convulsions within an hour (Treiman 1994), SE is due to a failure of the mechanisms that terminate individual seizures. It is a potentially life-threatening condition which may produce profound systemic and irreversible neuronal damage. The principles of treating SE should be set to (1) stop the seizures; (2) search for potential precipitating causes; (3) prevent seizure recurrence; and (4) treat complications and underlying conditions. SE should be treated as a medical emergency since even in modern hospital settings the mortality of SE may reach 15-80%. |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。