Obravnava epileptičnega statusa pri odraslih
DOI:
https://doi.org/10.6016/ZdravVestn.3436Ključne besede:
elektroencefalografija, epileptični status, patofiziologija, zdravljenjePovzetek
Epileptični status (ES) je resno in pogosto nevrološko urgentno stanje z visoko obolevnostjo in smrtnostjo. Po etiološki razvrstitvi je lahko simptomatski ali kriptogeni oz. brez znanega vzroka. Klinično ga razdelimo v 4 faze: zgodnji, napredovali, refraktorni (RES) in superrefraktorni ES (SRES). Tudi zdravljenje je temu primerno stopenjsko. V prvi fazi damo benzodiazepin, nato zdravljenje nadaljujemo z bolj specifičnimi protiepileptičnimi zdravili. Ko se razvije RES, bolniki večinoma potrebujejo zdravljenje s splošnimi anestetiki v enotah intenzivne terapije (EIT). Elektroencefalografija (EEG) je dobra diagnostična metoda, ki v določenih primerih (nekonvulzivni ES, žariščni ES, RES in SRES) z novimi izkušnjami in znanjem postaja nepogrešljiva pri obravnavi bolnikov z ES. Kljub resnosti in urgentnosti stanja lahko z ustrezno obravnavo in zdravljenjem močno izboljšamo napoved izida pri bolniku in zmanjšamo smrtnost.
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