癫痫持续状态研究进展_Journal of Epilepsy

Authors：

 韩春涛 ,  林卫红

吉林大学第一医院神经内科, 长春, 130021;

Corresponding author：

林卫红, Email: linweihong321@126.com

Keywords：

癫痫持续状态; 定义; 分类; 脑电图; 抗癫痫药物

DOI：

10.7507/2096-0247.20160009

Video：

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Abstract Full text Figures/Tables Video References Cited by

从国内外研究现状出发, 对癫痫持续状态(Status epilepticus, SE)的定义、流行病学和病因、发病机制、分类、诊断评估、治疗及预后等进行了全面阐述。有关SE定义的历史变迁, 从理论性定义到实用性定义均给出了明确界定, 其中实用性定义为适应人们对SE病理生理机制的进一步理解和满足临床容易操作需要不断更新。国际抗癫痫联盟(ILAE)已对强直-阵挛SE、复杂部分发作SE和失神SE实用性定义给出了明确规定。并对SE的流行病学及病因进行了探讨, 多种神经系统及全身性病理生理改变可导致SE, 发作自我维持与自我终止的平衡破坏是SE发生的必要条件, 发作导致神经系统兴奋性和抑制性系统失衡, 后者反过来又促进发作持续。有关SE分类一直备受关注, 几经变迁, 最新方案重新按惊厥性和非惊厥性分为两大类。诊断需依靠脑电图监测, 尤其非惊厥类型, 典型癫痫发作且持续时间足够长, 可无需脑电图监测证据。神经影像及实验室检查有助于发现病因。SE为神经科急症, 尽早控制发作, 并应与详细的病史采集同时进行, 院前积极给药明显增加SE控制率, 咪达唑仑和苯二氮卓类为首选药物。对难治性SE及早应用麻醉药物, 可减少并发症及死亡率, 提高控制率

Citation： 韩春涛, 林卫红. 癫痫持续状态研究进展. Journal of Epilepsy, 2016, 2(1): 43-47. doi: 10.7507/2096-0247.20160009 Copy

1.	Gastaut H. Clinical and electroencephalographical classification of epileptic seizures. Epilepsia, 1970, 11(3): 102-113.
2.	Jean Bancaud, Olaf Henriksen, Francisco Rubio-Donnadieu, et al. Proposal for revised clinical and electroencephalographic classification of epileptic seizures. Epilepsia, 1981, 22(10): 489-501.
3.	Blume WT, Luder HO, Mizrahi E, et al. Glassoary of descriptive terminology for ictal seminology:report of ILAE task force on classification and teiminology. Epilepsia, 2001, 42(13): 1212-1218.
4.	Boone, C Roger. Treatment of convulsive status epilepticus. JAMA, 1993, 270(10): 854-859.
5.	Chen JW, Wasterlain CG.Status epilepticus:pathophisiology and managemengt in adults.Lancet Neurol, 2006, 5(2): 246-256.
6.	Lowenstein DH, Bleck T, Macdonald RL.It is time to revise the definition of status epilepticus. Epilepticus, 1999, 40(4): 120-122.
7.	Scott RC. Convulsive status epilepticus in children.In Panayiotopoulos CP, ed. A practical guide to childhood epilepsy. Oxford: Medicine, 2006, 1: 58-68.
8.	Raspall Chaure M, Chin RF, Neville BG, et al.Outcome of paediatric convulsive status epilepticus:a systemtic review. Lancet Neurol, 2006, 5(2): 769-779.
9.	Dobesberger J, Risti c AJ, Walser G, et al. Duration of focal complex, secondarily generalized tonic-clonic, and primarily generalized tonic-clonic seizures-a video-EEG analysis. Epilepsy Behav, 2015, 49(8): 111-117.
10.	Eugen Trinka, Hannah Cock, Dale Hesdorffer, et al. A definition and classification of status epilepticureport of the ILAE task force on classification of status epilepticus. Epilepsia, 2015, 56(13): 1515-1523.
11.	Treatment of convulsive status epilepticus. Recommendations of the epilepsy foundation of america's working group on status epilepticus. JAMA, 1993, 270(43): 854-859.
12.	Guidelines for epidemiologic studies on epilepsy. Commission on epidemiology and prognosis, International League Against Epilepsy. Epilepsia, 1993, 34(11): 592-596.
13.	Hesdorffer DC, Benn EK, Bagiella E, et al. Distribution of febrile seizure duration and associations with development. Ann Neurol, 2011, 70(21): 93-100.
14.	Knake S, Rosenow F, Vescovi M, et al. Incidence of status epilepticus in adults in germany: a prospective, population-based study. Epilepsia, 2001, 42(9): 714-718.
15.	Coeytaux A, Jallon P, Galobardes B, et al. Incidence of status epilepticus in french-speaking switzerland: (EPISTAR). Neurology, 2000, 55(10): 693-697.
16.	Vignatelli L, Tonon C, D'Alessandro R, et, al. Incidence and short-term prognosis of status epilepticus in adults in bologna italy. Epilepsia, 2003, 44(20): 964-968.
17.	Hesdorffer DC, Logroscino G, Cascino G, et al. Incidence of status epilepticus in rochester, minnesota, 1965-1984. Neurology, 1998, 50(17): 735-741.
18.	Hauser WA. Status epilepticus: epidemiologic considerations. Neurology, 1990, 40 (Suppl 2): 9-13.
19.	Dham BS, Hunter K, Rincon F. The epidemiology of status epilepticus in the united states. Neurocrit Care, 2014, 20(3): 476-483.
20.	Waterhouse E, Kaplan P. The causes of convulsive status epilepticus in adults. In: Shorvon SE, Andermann F, Guerrini, editors. The Causes of epilepsy: common and uncommon causes in adults and children. Cambridge: Cambridge University Press. 2011: 735-736.
21.	Rossetti AO, Hurwitz S, Logroscio G, et al. Prognosis of status epilepticus: role of aetiology, age and consciousness impairment at presentation. J Neurol Neurosurg Psychiatry, 2006, 77(5): 611-615.
22.	Tiamkao S, Pranbul S, Saw anyawisuth K, et al. A national d tabase of incidence and treatment outcomes of status epilepticus in Thailand. Int J Neuosci, 2014, 124(6): 416-420.
23.	Hui AC, Joynt GM, Li H, et al. Status epilepticus in hong kong chinese: aetiology, outcome and predictors of death and morbidity.Seisure, 2003, 12(7): 478-482.
24.	John P Betjemann, Daniel H Lowenstein. Status epilepticus in adults. Lancet Neurol, 2015, 14(2): 615-624.
25.	Dr Michael Kinney, Dr John Craig. Grand rounds: an update on convulsive status epilepticus. Ulster Med J, 2015, 84(2): 88-93.
26.	Chen JW, Naylor DE, Wasterlain CG. Advances in the pathophysiology of status epilepticus. Acta Neurol Scand Suppl, 2007, 186(24): 7-15.
27.	Naylor DE, Liu H, Wasterlain CG. Trafficking of GABA(A) receptors, loss of inhibition and a mechanism for pharmacoresistance in status epilepticus. J Neurosci, 2005, 25(8): 7724-7733.
28.	Goodkin HP, Sun C, Yeh JL, et al. GABA(A) receptor internalization during seizures. Epilepsia, 2007, 48 (Suppl 5): 1009-1013.
29.	Naylor DE, Liu H, Niquet J, et al. Rapid surface accumulation of NMDA receptors increases glutamatergic excitation during status epilepticus. Neurobiol Dis, 2013, 54(10): 225-238.
30.	Chen JW, Wasterlain CG. Status epilepticus: pathophysiology and management in adults.Lancet Neurol, 2006, 5(3): 246-256.
31.	Kapur J, Macdonald RL. Rapid seizure-induced reduction of benzodiazepine and Zn²⁺ sensitivity of hippocampal dentate granule cell GABA A receptors. J Neurosci, 1997, 17(12): 7532-7540.
32.	Jones DM, Esmaeil N, Maren S, et al. Characterization of pharmacoresistance to benzodiazepines in the rat Lipilocarpine model of status epilepticus. Epilepsy Res, 2002, 50(17): 301-312.
33.	Shorvon S. The management of status epilepticus. J Neurol Neurosurg Psychiatry, 2001, 70(Suppl II): 22-27.
34.	Engel J Jr. Report of the ILAE classification core group. Epilepsia, 2006, 47(8): 1558-1568.
35.	Shorvon S. What is nonconvulsive status epilepticus and what are its subtypes? Epilepsia, 2007, 48 (Suppl 8): 35-38.
36.	Riiegg S. Non-convulsive status epilepticus in adults-an overview. Schweiz Arch Neurol Psvchiatr, 2008, 159(221): 53-83.
37.	José L Fernández-Torre, Peter W Kaplan, Miguel A. Hernández-Hernández. New understanding of Nonconvulsive status epilepticus in adults: Treatments and challenges. Expert Review of Neurotherapeutics, 2015, 15(12): 1455-1473.
38.	Meierkord H, Holtkamp M. Non-convulsive status epilepticus in adults: clinical forms and treatment. Lancet Neurol, 2007, 6(3): 329-339.
39.	DeLorenzo RJ, Waterhouse EJ, Towne AR, et al. Persistent nonconvulsive status epilepticus after the control of convulsive status epilepticus. Epilepsia, 1998, 39(8): 833-840.
40.	owne AR, Waterhouse EJ, Boggs JG, et al.Prevalence of nonconvulsive statusepilepticus in comatose patients. Neurology, 2000, 54(2): 340-345.
41.	arayanan JT, Murthy JM.Nonconvulsive status epilepticus in a neurological intensive care unit:profile in a developing country. Epilepsia, 2007, 48(5): 900-906.
42.	Kramer RE, Lüders H, Lesser RP, et al. Transient focal abnormalities of neuroimaging studies during focal status epilepticus. Epilepsia, 1987, 28(10): 528-532.
43.	Boyd JG, Taylor S, Rossiter JP, et al. New-onset refractory status epilepticus with restricted DWI and neuronophagia in the pulvinar. Neurology, 2010, 74(11): 1003-1005.
44.	Shinnar S, Bello JA, Chan S, et al. MRI abnormalities following febrile status epilepticus in children: the FEBSTAT study. Neurology, 2012, 79(12): 871-877.
45.	Cianfoni A, Caulo M, Cerase A, et al. Seizure-induced brain lesions: a wide spectrum of variably reversible MRI abnormalities. Eur J Radiol, 2013, 82(17): 1964-1972.
46.	Cartagena AM, Young GB, Lee DH, et al. Reversible and irreversible cranial MRI findings associated with status epilepticus. Epilepsy Behav, 2014, 33(2): 24-30.
47.	Bauer G, Gotwald T, Dobesberger J, et al. Transient and permanent magnetic resonance imaging abnormalities after complex partial status epilepticus. Epilepsy Behav, 2006, 8(2): 666-671.
48.	Lewis DV, Shinnar S, Hesdorff er DC, et al, and the FEBSTAT Study Team. Hippocampal sclerosis after febrile status epilepticus: the FEBSTAT study. Ann Neurol, 2014, 75(11): 178-185.
49.	Silbergleit R, Durkalski V, Lowenstein D, et al. Intramuscular versus intravenous therapy for prehospital status epilepticus. N Engl J Med, 2012, 366(56): 591-600.
50.	Lowenstein DH, Alldredge BK. Status epilepticus. N Engl J Med, 1998, 338(14): 970-976.
51.	Yasiry Z, Shorvon SD. The relative effectiveness of five antiepileptic drugs in treatment of benzodiazepine-resistant convulsive status epilepticus: a meta-analysis of published studies. Seizure, 2014, 23(3): 167-174.
52.	Cock HR, and the ESETT Group. Established status epilepticus treatment trial (ESETT). Epilepsia, 2011, 52 (Suppl 8): 50-52.
53.	Kellinghaus C, Berning S, Immisch I, et al. Intravenous lacosamide for treatment of status epilepticus. Acta Neurol Scand, 2011, 123(7): 137-141.
54.	Höfler J, Unterberger I, Dobesberger J, et al. Intravenous lacosamide in status epilepticus and seizure clusters. Epilepsia, 2011, 52(2): e148-152.
55.	Ahmad Bayrlee, Nimalya Ganeshalingam, Lisa Kurczewski, et al. Treatment of super-refractory status epilepticus. Curr Neurol Neurosci Rep, 2015, 15(7): 66.
56.	Sutter R, Marsch S, Fuhr P, et al. Anesthetic drugs in status epilepticus: risk or rescue? A 6-year cohort study. Neurology, 2014, 82(16): 656-664.
57.	Shorvon S, Ferlisi M. The treatment of super-refractory status epilepticus: a critical review of available therapies and a clinical treatment protocol. Brain, 2011, 134(Pt 10): 2802-2818.
58.	Mnatsakanyan L, Chung JM, Tsimerinov EI, et al. Intravenous lacosamide in refractory nonconvulsive status epilepticus. Seizure, 2012, 21(3):198-201.
59.	Miro J, Toledo M, Santamarina E, et al. Efficacy of intravenous lacosamide as an add-on treatment in refractory status epilepticus: a multicentric prospective study. Seizure, 2013, 22(1): 77-79.
60.	laassen J, Hirsch LJ, Emerson RG, et al. Treatment of refractory status epilepticus with pentobarbital, propofol, or midazolam:a systematic review.Epilepsia, 2002, 43(8):146-153.
61.	Zeiler FA, Zeiler KJ, Teitelbaum J, et al. VNS for refractory status epilepticus. Epilepsy Res, 2015, 112(0): 100-113.

1. Gastaut H. Clinical and electroencephalographical classification of epileptic seizures. Epilepsia, 1970, 11(3): 102-113.
2. Jean Bancaud, Olaf Henriksen, Francisco Rubio-Donnadieu, et al. Proposal for revised clinical and electroencephalographic classification of epileptic seizures. Epilepsia, 1981, 22(10): 489-501.
3. Blume WT, Luder HO, Mizrahi E, et al. Glassoary of descriptive terminology for ictal seminology:report of ILAE task force on classification and teiminology. Epilepsia, 2001, 42(13): 1212-1218.
4. Boone, C Roger. Treatment of convulsive status epilepticus. JAMA, 1993, 270(10): 854-859.
5. Chen JW, Wasterlain CG.Status epilepticus:pathophisiology and managemengt in adults.Lancet Neurol, 2006, 5(2): 246-256.
6. Lowenstein DH, Bleck T, Macdonald RL.It is time to revise the definition of status epilepticus. Epilepticus, 1999, 40(4): 120-122.
7. Scott RC. Convulsive status epilepticus in children.In Panayiotopoulos CP, ed. A practical guide to childhood epilepsy. Oxford: Medicine, 2006, 1: 58-68.
8. Raspall Chaure M, Chin RF, Neville BG, et al.Outcome of paediatric convulsive status epilepticus:a systemtic review. Lancet Neurol, 2006, 5(2): 769-779.
9. Dobesberger J, Risti c AJ, Walser G, et al. Duration of focal complex, secondarily generalized tonic-clonic, and primarily generalized tonic-clonic seizures-a video-EEG analysis. Epilepsy Behav, 2015, 49(8): 111-117.
10. Eugen Trinka, Hannah Cock, Dale Hesdorffer, et al. A definition and classification of status epilepticureport of the ILAE task force on classification of status epilepticus. Epilepsia, 2015, 56(13): 1515-1523.
11. Treatment of convulsive status epilepticus. Recommendations of the epilepsy foundation of america's working group on status epilepticus. JAMA, 1993, 270(43): 854-859.
12. Guidelines for epidemiologic studies on epilepsy. Commission on epidemiology and prognosis, International League Against Epilepsy. Epilepsia, 1993, 34(11): 592-596.
13. Hesdorffer DC, Benn EK, Bagiella E, et al. Distribution of febrile seizure duration and associations with development. Ann Neurol, 2011, 70(21): 93-100.
14. Knake S, Rosenow F, Vescovi M, et al. Incidence of status epilepticus in adults in germany: a prospective, population-based study. Epilepsia, 2001, 42(9): 714-718.
15. Coeytaux A, Jallon P, Galobardes B, et al. Incidence of status epilepticus in french-speaking switzerland: (EPISTAR). Neurology, 2000, 55(10): 693-697.
16. Vignatelli L, Tonon C, D'Alessandro R, et, al. Incidence and short-term prognosis of status epilepticus in adults in bologna italy. Epilepsia, 2003, 44(20): 964-968.
17. Hesdorffer DC, Logroscino G, Cascino G, et al. Incidence of status epilepticus in rochester, minnesota, 1965-1984. Neurology, 1998, 50(17): 735-741.
18. Hauser WA. Status epilepticus: epidemiologic considerations. Neurology, 1990, 40 (Suppl 2): 9-13.
19. Dham BS, Hunter K, Rincon F. The epidemiology of status epilepticus in the united states. Neurocrit Care, 2014, 20(3): 476-483.
20. Waterhouse E, Kaplan P. The causes of convulsive status epilepticus in adults. In: Shorvon SE, Andermann F, Guerrini, editors. The Causes of epilepsy: common and uncommon causes in adults and children. Cambridge: Cambridge University Press. 2011: 735-736.
21. Rossetti AO, Hurwitz S, Logroscio G, et al. Prognosis of status epilepticus: role of aetiology, age and consciousness impairment at presentation. J Neurol Neurosurg Psychiatry, 2006, 77(5): 611-615.
22. Tiamkao S, Pranbul S, Saw anyawisuth K, et al. A national d tabase of incidence and treatment outcomes of status epilepticus in Thailand. Int J Neuosci, 2014, 124(6): 416-420.
23. Hui AC, Joynt GM, Li H, et al. Status epilepticus in hong kong chinese: aetiology, outcome and predictors of death and morbidity.Seisure, 2003, 12(7): 478-482.
24. John P Betjemann, Daniel H Lowenstein. Status epilepticus in adults. Lancet Neurol, 2015, 14(2): 615-624.
25. Dr Michael Kinney, Dr John Craig. Grand rounds: an update on convulsive status epilepticus. Ulster Med J, 2015, 84(2): 88-93.
26. Chen JW, Naylor DE, Wasterlain CG. Advances in the pathophysiology of status epilepticus. Acta Neurol Scand Suppl, 2007, 186(24): 7-15.
27. Naylor DE, Liu H, Wasterlain CG. Trafficking of GABA(A) receptors, loss of inhibition and a mechanism for pharmacoresistance in status epilepticus. J Neurosci, 2005, 25(8): 7724-7733.
28. Goodkin HP, Sun C, Yeh JL, et al. GABA(A) receptor internalization during seizures. Epilepsia, 2007, 48 (Suppl 5): 1009-1013.
29. Naylor DE, Liu H, Niquet J, et al. Rapid surface accumulation of NMDA receptors increases glutamatergic excitation during status epilepticus. Neurobiol Dis, 2013, 54(10): 225-238.
30. Chen JW, Wasterlain CG. Status epilepticus: pathophysiology and management in adults.Lancet Neurol, 2006, 5(3): 246-256.
31. Kapur J, Macdonald RL. Rapid seizure-induced reduction of benzodiazepine and Zn²⁺ sensitivity of hippocampal dentate granule cell GABA A receptors. J Neurosci, 1997, 17(12): 7532-7540.
32. Jones DM, Esmaeil N, Maren S, et al. Characterization of pharmacoresistance to benzodiazepines in the rat Lipilocarpine model of status epilepticus. Epilepsy Res, 2002, 50(17): 301-312.
33. Shorvon S. The management of status epilepticus. J Neurol Neurosurg Psychiatry, 2001, 70(Suppl II): 22-27.
34. Engel J Jr. Report of the ILAE classification core group. Epilepsia, 2006, 47(8): 1558-1568.
35. Shorvon S. What is nonconvulsive status epilepticus and what are its subtypes? Epilepsia, 2007, 48 (Suppl 8): 35-38.
36. Riiegg S. Non-convulsive status epilepticus in adults-an overview. Schweiz Arch Neurol Psvchiatr, 2008, 159(221): 53-83.
37. José L Fernández-Torre, Peter W Kaplan, Miguel A. Hernández-Hernández. New understanding of Nonconvulsive status epilepticus in adults: Treatments and challenges. Expert Review of Neurotherapeutics, 2015, 15(12): 1455-1473.
38. Meierkord H, Holtkamp M. Non-convulsive status epilepticus in adults: clinical forms and treatment. Lancet Neurol, 2007, 6(3): 329-339.
39. DeLorenzo RJ, Waterhouse EJ, Towne AR, et al. Persistent nonconvulsive status epilepticus after the control of convulsive status epilepticus. Epilepsia, 1998, 39(8): 833-840.
40. owne AR, Waterhouse EJ, Boggs JG, et al.Prevalence of nonconvulsive statusepilepticus in comatose patients. Neurology, 2000, 54(2): 340-345.
41. arayanan JT, Murthy JM.Nonconvulsive status epilepticus in a neurological intensive care unit:profile in a developing country. Epilepsia, 2007, 48(5): 900-906.
42. Kramer RE, Lüders H, Lesser RP, et al. Transient focal abnormalities of neuroimaging studies during focal status epilepticus. Epilepsia, 1987, 28(10): 528-532.
43. Boyd JG, Taylor S, Rossiter JP, et al. New-onset refractory status epilepticus with restricted DWI and neuronophagia in the pulvinar. Neurology, 2010, 74(11): 1003-1005.
44. Shinnar S, Bello JA, Chan S, et al. MRI abnormalities following febrile status epilepticus in children: the FEBSTAT study. Neurology, 2012, 79(12): 871-877.
45. Cianfoni A, Caulo M, Cerase A, et al. Seizure-induced brain lesions: a wide spectrum of variably reversible MRI abnormalities. Eur J Radiol, 2013, 82(17): 1964-1972.
46. Cartagena AM, Young GB, Lee DH, et al. Reversible and irreversible cranial MRI findings associated with status epilepticus. Epilepsy Behav, 2014, 33(2): 24-30.
47. Bauer G, Gotwald T, Dobesberger J, et al. Transient and permanent magnetic resonance imaging abnormalities after complex partial status epilepticus. Epilepsy Behav, 2006, 8(2): 666-671.
48. Lewis DV, Shinnar S, Hesdorff er DC, et al, and the FEBSTAT Study Team. Hippocampal sclerosis after febrile status epilepticus: the FEBSTAT study. Ann Neurol, 2014, 75(11): 178-185.
49. Silbergleit R, Durkalski V, Lowenstein D, et al. Intramuscular versus intravenous therapy for prehospital status epilepticus. N Engl J Med, 2012, 366(56): 591-600.
50. Lowenstein DH, Alldredge BK. Status epilepticus. N Engl J Med, 1998, 338(14): 970-976.
51. Yasiry Z, Shorvon SD. The relative effectiveness of five antiepileptic drugs in treatment of benzodiazepine-resistant convulsive status epilepticus: a meta-analysis of published studies. Seizure, 2014, 23(3): 167-174.
52. Cock HR, and the ESETT Group. Established status epilepticus treatment trial (ESETT). Epilepsia, 2011, 52 (Suppl 8): 50-52.
53. Kellinghaus C, Berning S, Immisch I, et al. Intravenous lacosamide for treatment of status epilepticus. Acta Neurol Scand, 2011, 123(7): 137-141.
54. Höfler J, Unterberger I, Dobesberger J, et al. Intravenous lacosamide in status epilepticus and seizure clusters. Epilepsia, 2011, 52(2): e148-152.
55. Ahmad Bayrlee, Nimalya Ganeshalingam, Lisa Kurczewski, et al. Treatment of super-refractory status epilepticus. Curr Neurol Neurosci Rep, 2015, 15(7): 66.
56. Sutter R, Marsch S, Fuhr P, et al. Anesthetic drugs in status epilepticus: risk or rescue? A 6-year cohort study. Neurology, 2014, 82(16): 656-664.
57. Shorvon S, Ferlisi M. The treatment of super-refractory status epilepticus: a critical review of available therapies and a clinical treatment protocol. Brain, 2011, 134(Pt 10): 2802-2818.
58. Mnatsakanyan L, Chung JM, Tsimerinov EI, et al. Intravenous lacosamide in refractory nonconvulsive status epilepticus. Seizure, 2012, 21(3):198-201.
59. Miro J, Toledo M, Santamarina E, et al. Efficacy of intravenous lacosamide as an add-on treatment in refractory status epilepticus: a multicentric prospective study. Seizure, 2013, 22(1): 77-79.
60. laassen J, Hirsch LJ, Emerson RG, et al. Treatment of refractory status epilepticus with pentobarbital, propofol, or midazolam:a systematic review.Epilepsia, 2002, 43(8):146-153.
61. Zeiler FA, Zeiler KJ, Teitelbaum J, et al. VNS for refractory status epilepticus. Epilepsy Res, 2015, 112(0): 100-113.

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