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首页> 外文期刊>CNS neuroscience & therapeutics. >Treatment of Status Epilepticus with Ketamine, Are we There yet?
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Treatment of Status Epilepticus with Ketamine, Are we There yet?

机译：用氯胺酮治疗癫痫持续状态，我们还在那里吗？

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Summary Status epilepticus ( SE ), a neurological emergency both in adults and in children, could lead to brain damage and even death if untreated. Generalized convulsive SE ( GCSE ) is the most common and severe form, an example of which is that induced by organophosphorus nerve agents. First‐ and second‐line pharmacotherapies are relatively consensual, but if seizures are still not controlled, there is currently no definitive data to guide the optimal choice of therapy. The medical community seems largely reluctant to use ketamine, a noncompetitive antagonist of the N ‐methyl‐ d ‐aspartate glutamate receptor. However, a review of the literature clearly shows that ketamine possesses, in preclinical studies, antiepileptic properties and provides neuroprotection. Clinical evidences are scarcer and more difficult to analyze, owing to a use in situations of polytherapy. In absence of existing or planned randomized clinical trials, the medical community should make up its mind from well‐conducted preclinical studies performed on appropriate models. Although potentially active, ketamine has no real place for the treatment of isolated seizures, better accepted drugs being used. Its best usage should be during GCSE , but not waiting for SE to become totally refractory. Concerns about possible developmental neurotoxicity might limit its pediatric use for refractory SE .
机译：总结癫痫持续状态（SE）是成年人和儿童的神经系统紧急情况，如果不及时治疗，可能导致脑部损伤甚至死亡。全身性惊厥性SE（GCSE）是最常见和最严重的形式，其中一个例子是由有机磷神经毒剂引起的。一线和二线药物治疗是相对同意的，但是如果癫痫发作仍未得到控制，则目前尚无确切的数据来指导最佳治疗选择。医学界似乎不太愿意使用氯胺酮，后者是N-甲基-d-天冬氨酸谷氨酸受体的非竞争性拮抗剂。但是，对文献的回顾清楚地表明，在临床前研究中，氯胺酮具有抗癫痫作用并具有神经保护作用。由于在多药治疗的情况下使用，临床证据稀少且更难分析。在没有现有的或计划的随机临床试验的情况下，医学界应从对适当模型进行的良好临床前研究中做出决定。氯胺酮虽然具有潜在的活性，但在治疗孤立的癫痫发作方面却没有真正的位置，人们正在使用公认的药物。它的最佳用法应该是在GCSE期间，而不要等待SE变得完全难熔。对可能的发展性神经毒性的担忧可能会限制其在难治性SE中的儿科应用。

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