BMJ Best Practice
最后审核时间： 六月 2019
最近更新时间： 三月 2019

小结

定义

病史和查体

关键诊断因素

  • 存在的危险因素
  • 持续性或反复性强直阵挛发作伴意识水平改变（全身惊厥性 SE）
  • 意识改变/意识模糊（非惊厥性 SE）
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其他诊断因素

  • 长期局灶性运动活动或者感觉或自主神经性症状，且意识完全清醒（意识正常型局灶性 SE）
  • 低血氧饱和度
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危险因素

  • 对抗惊厥药物不依从。
  • 慢性酒精中毒
  • 难治性癫痫
  • 毒性或代谢性病因
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诊断性检查

首要检查

  • 抗惊厥药物的血浓度水平
  • 毒理学筛查
  • 综合代谢检查
  • 全血细胞计数 (FBC）
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需要考虑的检查

  • 动脉血气 (ABG)
  • 脑部 CT
  • 腰椎穿刺：
  • 头部 MRI
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治疗流程

急性

全面惊厥性癫痫持续状态

非惊厥性癫痫持续状态

意识正常型局灶性（单纯部分性）癫痫持续状态

贡献者

作者 查看所有

Professor of Neurology and Neurosurgery

Johns Hopkins Medical Institutions

Baltimore

MD

利益冲突披露
RPL's wife holds shares in Abbott Laboratories, which makes Depakote, a brand formulation of valproate/divalproex. RPL holds shares in Abbvie, Express Scripts, Halgene, Halyard Health, Hospira, Johnson and Johnson (which makes Topamax, a brand formulation of topiramate), Merck and Company, and Pfizer (which makes Dilantin and Cerebyx, brand formulations of phenytoin and fosphenytoin, respectively).

Assistant Professor of Neurology

Johns Hopkins Medical Institutions

Baltimore

MD

利益冲突披露
EJ declares that she has no competing interests.

Dr Ronald P. Lesser and Dr Emily Johnson would like to gratefully acknowledge Dr Mohammad Koubeissi and Dr Nabil Azar, previous contributors to this topic.

利益冲突披露
NJA declares that he has no competing interests. MZK declares that he has no competing interests.

Consultant Neurologist

John Radcliffe Hospital

Oxford

UK

利益冲突披露
YH has been reimbursed by UCB Pharma Ltd, Janssen-Cilag Ltd, Pfizer Ltd, and Eisai Ltd for attending conferences; has taught at meetings sponsored by the above companies and by GlaxoSmithKline Services Unlimited; and has received payment for advisory board work from UCB Pharma Ltd, Janssen-Cilag Ltd, Eisai Ltd, and GlaxoSmithKline Services Unlimited.

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