tonicclonic status epilepticus in children广义强直阵挛性癫痫持续状态的儿童课件

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1、Generalized,Tonic-ClonicStatusEpilepticusinChildrenMichaelWilson,MDPediatricCriticalCareObjectivesTheparticipantwillincreaseher/hisabilitytodefinestatusepilepticususingapractical,mechanisticapproachabilitytolistprobablecausesforstatusepilepticusinchildrenunderstandingoft

2、hepathophysiologiceventsknowledgeoftreatmentstrategiesforpediatricstatusepilepticus2StatusepilepticusStatusepilepticus(SE)presentsinamultitudeofforms,dependentonetiologyandpatientage(myoclonic,tonic,subtle,tonic-clonic,absence,complexpartialetc.)Generalized,tonic-clonicS

3、E(GCSE)isthemostcommonformofSEThefollowingpresentationreferstogeneralized,tonic-clonicSE3StatusepilepticusDefinitionInternationalLeagueAgainstEpilepsySingleseizure>30minutes2ormoreseizureswithoutcompleterecoveryofconsciousnessbetweenseizures4StatusepilepticusWhy30minutes

4、?Animalexperimentsinthe1970sand1980shadshownthat...…neuronalinjurycouldbedemonstratedafter30minofseizureactivity,evenwhilemaintainingrespirationandcirculationNevanderG.AnnNeurol1985;18(3):281-90.5StatusepilepticusMorepractical:MechanisticdefinitionGCSEisaconditionwhichmo

5、stlikelywillnotterminaterapidlyand/orspontaneouslyGCSEisaconditionwhichrequirespromptinterventionLowensteinDH.Epilepsia19996StatusepilepticusThelongerSEpersists,theloweristhelikelihoodofspontaneouscessationtheharderitistocontrolthehigheristheriskofmorbidityandmortalityBl

6、eckTP.Epilepsia1999;40(1):S64-6TheStatusEpilepticusWorkingParty.ArchDisChild2000;83(5):415-9.7StatusepilepticusTypicalseizuredurationChildren>5years:Typical,generalizedtonic-clonicseizurelasts<5minutesYoungchildrenandinfants:Paucityofdata.Suggestedtimeframefortypicaltoni

7、c-clonicseizure:<10-15minutesReviewedin:LowensteinDH.It'stimetorevisethedefinitionofstatusepilepticus.Epilepsia1999;40(1):120-2.8StatusepilepticusRevisedDefinitionGeneralized,convulsivestatusepilepticusinolderchildren(>5years)refersto>5minutesofcontinuousseizureor>2discr

8、eteseizureswithincompleterecoveryofconsciousnessPatientswithgeneralizedseizureactivityatarrivalintheERa