PDF(Pubmed)
Abstract：
UNASSIGNED: Acute repetitive seizures (ARSs) are one of the few commonly encountered neurological emergencies in children. There is a need for an appropriate timeline-based treatment protocol, which will be shown to be safe and efficacious in a clinical study.
UNASSIGNED: This was a retrospective chart review to determine the efficacy of a pre-specified treatment protocol for the management of ARSs in children aged 1-18 years. The treatment protocol was specifically applied in children with a diagnosis of epilepsy and not critically ill, who met the criteria for ARSs, with the exemption of new onset of ARSs. The first tier of treatment protocol focused on intravenous lorazepam, optimization of dose of existing anti-seizure medications (ASMs), and control of triggers like acute febrile illness, while second-tier focused on adding one or two additional ASMs, commonly used in cases with seizure clusters or status epilepticus.
UNASSIGNED: We included the first 100 consecutive patients (7.6 ± 3.2 years, 63% boys). Our treatment protocol was successful in 89 patients (58 and 31 required first-tier and second-tier treatment). The absence of pre-existing drug-resistant epilepsy and the presence of acute febrile illness as a triggering factor (P = 0.02 and 0.03) were associated with the success of the first tier of the treatment protocol. Excessive sedation (n = 29), incoordination (n = 14), transient gait instability (n = 11), and excessive irritability (n = 5) were the most common adverse effects observed during the initial 1 week.
UNASSIGNED: This pre-specified treatment protocol is safe and efficacious in controlling ARSs in cases with established epilepsy who are not critically sick. External validation from other parts of the world/centers and a more diverse epilepsy population are required before generalizing the protocol into clinical practice.
UNASSIGNED: This was a retrospective chart review to determine the efficacy of a pre-specified treatment protocol for the management of ARSs in children aged 1-18 years. The treatment protocol was specifically applied in children with a diagnosis of epilepsy and not critically ill, who met the criteria for ARSs, with the exemption of new onset of ARSs. The first tier of treatment protocol focused on intravenous lorazepam, optimization of dose of existing anti-seizure medications (ASMs), and control of triggers like acute febrile illness, while second-tier focused on adding one or two additional ASMs, commonly used in cases with seizure clusters or status epilepticus.
UNASSIGNED: We included the first 100 consecutive patients (7.6 ± 3.2 years, 63% boys). Our treatment protocol was successful in 89 patients (58 and 31 required first-tier and second-tier treatment). The absence of pre-existing drug-resistant epilepsy and the presence of acute febrile illness as a triggering factor (P = 0.02 and 0.03) were associated with the success of the first tier of the treatment protocol. Excessive sedation (n = 29), incoordination (n = 14), transient gait instability (n = 11), and excessive irritability (n = 5) were the most common adverse effects observed during the initial 1 week.
UNASSIGNED: This pre-specified treatment protocol is safe and efficacious in controlling ARSs in cases with established epilepsy who are not critically sick. External validation from other parts of the world/centers and a more diverse epilepsy population are required before generalizing the protocol into clinical practice.
摘要：
■急性重复性癫痫（ARSs）是儿童中少数常见的神经系统急症之一。需要适当的基于时间表的治疗方案，这将在临床研究中被证明是安全有效的。
■这是一项回顾性的图表审查，以确定预先指定的治疗方案对1-18岁儿童的ARSs管理的有效性。该治疗方案特别适用于诊断为癫痫且未危重的儿童，谁符合ARSs的标准，豁免新出现的ARSs。第一层治疗方案集中于静脉注射劳拉西泮，优化现有抗癫痫药物(ASM)的剂量，控制急性高热疾病等诱因，而第二层专注于添加一个或两个额外的ASM，通常用于癫痫发作或癫痫持续状态。
■我们纳入了前100名连续患者（7.6±3.2年，63%的男孩）。我们的治疗方案在89例患者中成功（58例和31例需要一级和二级治疗）。先前存在的耐药性癫痫和急性发热性疾病的存在作为触发因素（P=0.02和0.03）与第一层治疗方案的成功有关。过度镇静（n=29），不协调(n=14)，瞬时步态不稳定（n=11），过度烦躁(n=5)是最初1周内观察到的最常见的不良反应.
■这种预先指定的治疗方案在控制非危重的已确定癫痫患者的ARSs方面是安全有效的。在将方案推广到临床实践之前，需要来自世界其他地区/中心和更多样化的癫痫人群的外部验证。
■这是一项回顾性的图表审查，以确定预先指定的治疗方案对1-18岁儿童的ARSs管理的有效性。该治疗方案特别适用于诊断为癫痫且未危重的儿童，谁符合ARSs的标准，豁免新出现的ARSs。第一层治疗方案集中于静脉注射劳拉西泮，优化现有抗癫痫药物(ASM)的剂量，控制急性高热疾病等诱因，而第二层专注于添加一个或两个额外的ASM，通常用于癫痫发作或癫痫持续状态。
■我们纳入了前100名连续患者（7.6±3.2年，63%的男孩）。我们的治疗方案在89例患者中成功（58例和31例需要一级和二级治疗）。先前存在的耐药性癫痫和急性发热性疾病的存在作为触发因素（P=0.02和0.03）与第一层治疗方案的成功有关。过度镇静（n=29），不协调(n=14)，瞬时步态不稳定（n=11），过度烦躁(n=5)是最初1周内观察到的最常见的不良反应.
■这种预先指定的治疗方案在控制非危重的已确定癫痫患者的ARSs方面是安全有效的。在将方案推广到临床实践之前，需要来自世界其他地区/中心和更多样化的癫痫人群的外部验证。
