产后癫痫持续状态的临床改善1例

C. Obikili, Makshwar L. Kahansim, A. Ocheke
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引用次数: 1

摘要

癫痫持续状态是一种罕见的妊娠神经系统并发症,与显著的母体和胎儿发病率和死亡率相关。终止妊娠目前不是一种管理策略。临床病例35岁,已知癫痫患者,主诉多次惊厥2天,意识丧失1天。经检查,她昏迷,格拉斯哥昏迷评分为5/15,反复发作,血压正常。评估结果是癫痫持续状态,她很快就住进了重症监护室。她最终瘫痪了,需要使用机械通气。她自然分娩,随后好转,出院时口服卡马西平。该患者管理的关键方面支持癫痫持续状态可以模仿子痫。分娩后病情显著且逐渐好转,以及以前报道的类似病例表明,分娩可能需要被视为难治性癫痫持续状态的一种管理策略。
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Clinical improvement of status epilepticus after delivery: A case report
Status epilepticus is a rare neurological complication of pregnancy, associated with significant maternal and fetal morbidity and mortality. Termination of pregnancy is not currently a management strategy. The clinical case was 35-year-old known epileptic presented with complaints of multiple convulsions of 2 days and loss of consciousness of a day. On examination, she was unconscious, with Glasgow Coma Scale 5/15, having repeated seizures, and blood pressure was normal. The assessment was status epilepticus and she was shortly admitted into the intensive care unit. She was eventually paralyzed and put on mechanical ventilation. She had a spontaneous delivery, subsequently improved, and was discharged on oral carbamazepine. Key aspects of this patient's management buttressed that status epilepticus can mimic eclampsia. That she significantly and progressively improved following delivery and that previous similar cases have been reported brings to bear that delivery might need to be considered as a management strategy for refractory status epilepticus.
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