期刊
BRAIN & DEVELOPMENT
卷 31, 期 8, 页码 605-611出版社
ELSEVIER SCIENCE BV
DOI: 10.1016/j.braindev.2008.09.010
关键词
Acute encephalitis with refractory; Repetitive partial seizures
Objective: Acute encephalitis with refractory repetitive partial seizure (AERRPS) is a peculiar type of post-encephalitic/encephalopathic epilepsy. Here we report all analysis of AERRPS in a series of children and propose an effective treatment option for seizure control in these children. Methods: We retrospectively reviewed cases of AERRPS treated in a pediatric intensive care unit., between February 2002 and June 2006. Clinical characteristics were systemically assessed. Burst Suppression coma was induced by high-dose suppressive therapy; 24-h electroencephalogram (EEG) monitoring was performed oil each patient. The goal of treatment was to achieve complete clinical seizure control or burst-suppression pattern on EEG, aiming for all interburst interval of >5 s. Brain imaging was done for each patient. Results: There were nine patients (seven boys), aged 5-15 years. Clinical symptoms included fever (100%), upper respiratory symptoms (66.7%) and altered consciousness (66.7%). All patients received multiple high-dose suppressive drugs and were intubated with/without inotropic agents. Seizures in three patients were stopped after high-dose lidocaine infusion (6-8 mg/kg/h) in the acute stage and three patients were stopped after high dose phenobarbital (serum level 60-80 ug/mL) combined with high-dose oral topiramate (15-20 mg/kg/day). Follow-up for this study was 16-61 months. Two subjects died while seven developed epilepsy and/or neurologic deficits; none returned to baseline. All survivors were discharged and Continued multiple antiepileptic medications. Conclusions: Our data indicates that children with AERRPS have high mortality and morbidity rates. High-dose topiramate combined with high-dose lidocaine infusion or high-dose phenobarbital in the acute stage might be an effective treatment option for children with AERRPS. (C) 2008 Elsevier B.V. All rights reserved.
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