中国现代神经疾病杂志 ›› 2023, Vol. 23 ›› Issue (2): 104-109. doi: 10.3969/j.issn.1672-6731.2023.02.006

• 癫痫及发作性疾病 • 上一篇    下一篇

2 癫痫持续状态药物治疗进展

陆钦池   

  1. 200125 上海交通大学医学院附属仁济医院神经内科
  • 收稿日期:2023-02-18 出版日期:2023-02-25 发布日期:2023-03-01
  • 通讯作者: 陆钦池,Email:2429451757@qq.com
  • 基金资助:
    国家自然科学基金资助项目(项目编号:82071445)

Recent progress of drug therapy in status epilepticus

LU Qin-chi   

  1. Department of Neurology, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200125, China
  • Received:2023-02-18 Online:2023-02-25 Published:2023-03-01
  • Supported by:
    This study was supported by the National Natural Science Foundation of China (No. 82071445).

摘要: 癫痫持续状态是神经内科急危重症,随着定义、诊断和分类的更新,其终止发作的临床操作程序也随之更新,涌现出一线和二线抗癫痫发作药物治疗癫痫持续状态的高级别证据;相继出现难治性癫痫持续状态和超级难治性癫痫持续状态的临床研究,但证据级别较低;新发难治性癫痫持续状态与免疫机制相关,可采取免疫治疗;新批准的抗癫痫发作药物如布瓦西坦、吡仑帕奈和拉科酰胺可用于难治性癫痫持续状态和超级难治性癫痫持续状态的治疗;并基于当前研究证据提出针对不同发作类型的两种不同治疗方案升级操作流程。本文综述上述研究进展,以为临床提供更优治疗方案。

关键词: 癫痫持续状态, 药物疗法, 综述

Abstract: Status epilepticus (SE) is a critical and emergency condition in internal medicine and neurology. Recently, the concepts, definition, and classification of SE are revised, followed by renew of the protocol of management of SE. High level of evidence for the first and second-line antiepileptic seizure medicine (ASM) are available. The new studies for treatment of refractory status epilepticus (RSE) and super-refractory status epilepticus (SRSE) are appeared but evidence for these are still very low. In new-onset refractory status epilepticus (NORSE) patients without obvious cause after initial assessment, an underlying auto-immune cause was frequently found. Early immune therapy is then recommended by experts. Newer ASM such as brivaracetam (BRV), perampanel (PER), and lacosamide (LCM) may be considered to apply in RSE and SRSE. Based on current evidence, two different treatment regimens are proposed to avoid brain damages secondary to seizure activity. We are going to state above topics in this review in order to provide better therapeutic schedule.

Key words: Status epilepticus, Drug therapy, Review