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首页> 外文期刊>The Internet Journal of Neurology >Non-Convulsive Status Epilepticus Following Hemodynamically Unstable Atrial Fibrillation
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Non-Convulsive Status Epilepticus Following Hemodynamically Unstable Atrial Fibrillation

机译：血流动力学不稳定的心房颤动后非惊厥性癫痫持续状态

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Non-convulsive status epilepticus (NCSE) is an increasingly recognized condition in non-epileptic intensive care patients and is seen in up to 8% of patients in coma. NCSE can be a challenging diagnosis because clinical features include altered mental status in the absence of convulsive activity. In critical care patients, NCSE may be precipitated by a variety of conditions, such as infection, severe electrolyte disturbance, acute intoxication, sedative-hypnotics withdrawal and traumatic brain injury. However, NCSE following hemodynamically unstable atrial fibrillation has not been reported. This article describes a patient who developed NCSE after an episode of hemodynamically unstable atrial fibrillation resulting in systemic hypotension and cerebral hypoperfusion. Fosphenytoin failed to produce clinical improvement despite resolution of abnormal pattern on EEG, and complete recovery was achieved only after administration of lorazepam. In the intensive care patients, NCSE may occur following hemodynamic compromise, and cerebral hypoperfusion may play a role in precipitating NCSE. A high index of clinical suspicion is necessary to diagnose and treat NCSE, which may be rapidly reversed by the administration of benzodiazepines.
机译：非惊厥性癫痫持续状态（NCSE）在非癫痫重症监护患者中得到越来越多的认可，在多达8％的昏迷患者中可见。 NCSE可能是一项具有挑战性的诊断，因为临床特征包括在没有抽搐活动的情况下精神状态发生了改变。在重症监护患者中，NCSE可能是由多种情况引起的，例如感染，严重的电解质紊乱，急性中毒，镇静催眠药停用和颅脑外伤。但是，尚无血液动力学不稳定的心房颤动后的NCSE报道。本文介绍了在血液动力学不稳定的心房颤动发作后导致系统性低血压和脑灌注不足的情况下发展为NCSE的患者。尽管在脑电图上异常模式的消退，磷苯妥因仍未能产生临床改善，仅在给予劳拉西m后才能完全恢复。在重症监护患者中，NCSE可能在血流动力学受损后发生，并且脑灌注不足可能在促成NCSE中起作用。对NCSE进行诊断和治疗需要高度的临床怀疑，通过服用苯二氮卓类药物可以迅速逆转这种怀疑。

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