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首页> 外文期刊>Neurocritical care >Phenytoin, levetiracetam, and pregabalin in the acute management of refractory status epilepticus in patients with brain tumors.
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Phenytoin, levetiracetam, and pregabalin in the acute management of refractory status epilepticus in patients with brain tumors.

机译：苯妥英钠，左乙拉西坦和普瑞巴林对患有脑肿瘤的患者难治性癫痫持续状态的急性治疗。

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There were nearly 700,000 patients in the United States in 2010 living with brain tumor diagnoses. The incidence of seizures in this population is as high as 70% and is historically difficult to control. Approximately 30-40% of brain tumors patients who present with status epilepticus (SE) will not respond to typical therapy consisting of benzodiazepines and phenytoin (PHT), resulting in patients with refractory status epilepticus (RSE). RSE is usually treated with anesthetic doses of propofol or midazolam infusions. This therapy can have significant risk, particularly in patients with cancer.A retrospective chart review was performed on 23 patients with primary or metastatic brain tumors whose SE was treated with intravenous PHT, levetiracetam (LEV), and oral pregabalin (PGB).In all the patients under study, PHT or LEV was used as first-line therapy. PGB was typically used as third-line treatment. The median daily dose of PGB was 375 mg (usually divided BID or TID), and the median daily dose of LEV 3000 mg (usually divided BID). Cessation of SE was seen in 16/23 (70%) after administration of PHT, LEV, and PGB. SE was aborted, on average, 24 h after addition of the third antiepileptic drug. Only one patient in the responder group required intubation. Mortality rate was zero in the responder group. No adverse reactions to this medication regimen were observed.Our study suggests that the administration of PHT, LEV, and PGB in brain tumor patients with RSE is safe and highly effective.
机译：2010年，美国有将近70万名患有脑肿瘤的患者。该人群癫痫发作的发病率高达70％，历史上难以控制。表现为癫痫持续状态（SE）的脑肿瘤患者中，大约30-40％对包括苯二氮卓类和苯妥英钠（PHT）的典型疗法无反应，导致患有难治性癫痫持续状态（RSE）的患者。通常用麻醉剂量的异丙酚或咪达唑仑输注治疗RSE。该疗法可能具有重大风险，特别是对于癌症患者。回顾性图表回顾了23例原发性或转移性脑肿瘤患者，其SE均通过静脉内PHT，左乙拉西坦（LEV）和口服普瑞巴林（PGB）治疗。在研究的患者中，PHT或LEV被用作一线治疗。 PGB通常用作三线治疗。 PGB的中位日剂量为375 mg（通常为BID或TID），LEV的中位日剂量为3000 mg（通常为BID）。服用PHT，LEV和PGB后，有16/23（70％）的SE停止。添加第三种抗癫痫药物后，SE平均平均流产24小时。响应者组中只有一名患者需要插管。响应者组的死亡率为零。没有观察到对该药物治疗方案的不良反应。我们的研究表明，在患有RSE的脑肿瘤患者中PHT，LEV和PGB的给药是安全且高效的。

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