类固醇对蜱传脑膜脑炎超级难治性癫痫状态的影响

IF 1.8 Q3 CLINICAL NEUROLOGY
Christine Heuer , Claudio Togni , Marian Galovic , Anna Czernuszenko , Giovanna Brandi , Ignazio de Trizio
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引用次数: 0

摘要

我们报告了一例继发于蜱传脑炎(TBE)的独特的超级难治性癫痫状态(SRSE)病例,以评估类固醇治疗在这种情况下的治疗挑战和潜在益处。一名先前健康的 31 岁女性因发热、头痛、眩晕和脑膜炎入院,最终被诊断为蜱传脑炎。尽管接受了经验性抗菌治疗,但患者病情恶化,导致昏迷和 SRSE。患者接受了多种抗癫痫药物和镇静剂治疗,但效果不佳。由于颅内压升高和癫痫持续发作,患者开始接受类固醇治疗。使用地塞米松后,电图癫痫状态缓解,但患者出现了颅内压增高的临床症状,必须进行减压开颅手术。在联合使用抗癫痫药物后,患者的病情趋于稳定。尽管停止了 SRSE,但患者出院时仍处于微清醒状态,只是随着时间的推移逐渐好转。类固醇在结核性脑病中的应用尚存争议,有关其潜在益处的报道有限。在本病例中,类固醇的使用与 SRSE 的停止同时进行,考虑到其免疫调节作用,作者对其潜在益处进行了探讨。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Effects of steroids on super-refractory status epilepticus in tick-borne meningoencephalitis

We report a unique case of super-refractory status epilepticus (SRSE) secondary to tick-borne encephalitis (TBE) to evaluate the therapeutic challenges and potential benefits of steroid treatment in this context. A previously healthy 31-year-old woman was admitted to the hospital with fever, headache, vertigo, and meningismus, ultimately diagnosed with TBE. Despite empirical antimicrobial treatment, the patient’s condition deteriorated, leading to coma and SRSE. Various antiseizure medications and sedatives were administered without sustained success. Steroid treatment was initiated due to elevated intracranial pressure and persistent seizure activity. Following the administration of dexamethasone, electrographic status epilepticus resolved, though the patient developed clinical signs of increased intracranial pressure necessitating decompressive craniectomy. The patient’s condition stabilized with a combination of antiseizure medicazions. Despite cessation of SRSE, the patient remained in a minimally conscious state at discharge, showing only gradual improvement over time. The use of steroids in TBE is controversial, with limited reports of potential benefits. In this case, steroid administration coincided with the cessation of SRSE, and authors explore its potential benefit considering its immunomodulatory effects.

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来源期刊
Epilepsy and Behavior Reports
Epilepsy and Behavior Reports Medicine-Neurology (clinical)
CiteScore
2.70
自引率
13.30%
发文量
54
审稿时长
50 days
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