吸入麻醉和电惊厥治疗1例新发超长顽固性癫痫持续状态患儿的成功应用

IF 0.2 Q4 PEDIATRICS
B. Mehra, R. Sabharwal, A. Sachdev, Praveen Kumar, R. Mehta, Neeraj Gupta
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引用次数: 0

摘要

超难治性癫痫持续状态(SRSE)和延长性SRSE的治疗依赖于紧急癫痫发作控制,以尽量减少兴奋性脑损伤、其他形式的神经损伤和多种医学并发症。迄今为止,没有随机对照试验或明确的指导方针可用于SRSE的管理。我们报告了一例10岁以前健康的男性儿童患者,他表现为发热性疾病和新发作的延长SRSE,对多种抗癫痫药物(asm)变得难治性。麻醉诱导昏迷、14个asm、生酮饮食、免疫治疗均未能完全控制患者的SRSE。第22天,异氟醚吸入麻醉实现临床和脑电图癫痫控制,持续3周,但无法断奶。从第57天起,进行电休克治疗(共14次,完全控制癫痫发作)。他在第80天出院。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Successful Use of Inhalational Anesthesia and Electroconvulsive Therapy in a Child with New Onset Prolonged Super-Refractory Status Epilepticus
Abstract The treatment of super-refractory status epilepticus (SRSE) and prolonged SRSE rests on urgent seizure control to minimize excitotoxic cerebral damage, other forms of neurologic damage, and multiple medical complications. To date no randomized controlled trials or clear-cut guidelines are available for the management of SRSE. We reported the case of a 10-year-old previously healthy male child patient who presented with a febrile illness and new onset prolonged SRSE that became refractory to multiple antiseizure medications (ASMs). Coma induction with anesthetic agents, 14 ASMs, ketogenic diet, immunotherapy failed to completely control the SRSE in our patient. On day 22, clinical and electroencephalographic seizure control was achieved with isoflurane inhalation anesthesia, which was continued for 3 weeks but was unable to be weaned. From day 57 onwards, electroconvulsive therapy was administered (total 14 sessions that resulted in complete control of seizures). He was discharged on the 80th day.
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来源期刊
自引率
0.00%
发文量
21
期刊介绍: The Journal of Pediatric Epilepsy is an English multidisciplinary peer-reviewed international journal publishing articles on all topics related to epilepsy and seizure disorders, epilepsy surgery, neurology, neurosurgery, and neuropsychology in childhood. These topics include the basic sciences related to the condition itself, the differential diagnosis, natural history, and epidemiology of seizures, and the investigation and practical management of epilepsy (including drug treatment, neurosurgery and non-medical and behavioral treatments). Use of model organisms and in vitro techniques relevant to epilepsy are also acceptable. Journal of Pediatric Epilepsy provides an in-depth update on new subjects and current comprehensive coverage of the latest techniques used in the diagnosis and treatment of childhood epilepsy.
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