ЭПИЛЕПТИЧЕСКИЙ СТАТУС В ДЕТСКОМ ВОЗРАСТЕ: АСПЕКТЫ ИНТЕНСИВНОЙ ТЕРАПИИ В УСЛОВИЯХ СТАЦИОНАРА
Обзорная статья
Дата публикации: марта 28, 2024
Ключевые слова
эпилептический статус
дети
интенсивная терапия
дети
интенсивная терапия
Как цитировать
Быков Ю. В., Обедин А. Н., Фишер В. В., Яцук И. В., Волков Е. В. ЭПИЛЕПТИЧЕСКИЙ СТАТУС В ДЕТСКОМ ВОЗРАСТЕ: АСПЕКТЫ ИНТЕНСИВНОЙ ТЕРАПИИ В УСЛОВИЯХ СТАЦИОНАРА // Кремлевская медицина. Клинический вестник. 2024. Т. № 1. С. 22-27.
Аннотация
Эпилептический статус (ЭС) в детском возрасте представляет важную экстренную неврологическую патологию, требующей оказания качественной неотложной медицинской помощи в условиях стационара. ЭС может приводить к долгосрочным неврологическим осложнениям и летальным исходам, в связи с чем рассмотрение вопросов оказания экстренной помощи при данном состоянии является актуальным направлением современной педиатрической анестезиологии и реанимации. Несмотря на большое количество противоэпилептических препаратов (ПЭП) для купирования ЭС в педиатрической практике, остаётся много вопросов относительно их дозирования, путей введения, эффективности и сочетания. При интенсивной терапии ЭС вызывают большие проблемы формирование рефрактерных форм данной патологии, что резко снижает терапевтическую эффективность. Цель обзора – анализ и обсуждение литературы, посвящённой исследованию наиболее часто используемых ПЭП и схем лечения ЭС у детей в условиях стационара.Литература
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14. Amengual-Gual M. et al. Novel drugs and early polypharmacotherapy in status epilepticus // Seizure. – 2019. – № 68. – Р. 79-88. doi: 10.1016/j.seizure.2018.08.004.
15. Sanchez Fernandez I. et al. Pathophysiology of convulsive status epilepticus // Seizure. – 2019. – 68. – P. 16–21. doi: 10.1016/j.seizure.2018.08.002.
16. Walker M.C. Pathophysiology of Status Epilepticus // Neurosci Lett. – 2018. –№ 22. – Р. 84-91. doi: 10.1016/j.neulet.2016.12.044.
17. Burman R.J. et al. A comparison of parenteral phenobarbital vs. parenteral phenytoin as second-line management for pediatric convulsive status epilepticus in a resource-limited setting // Front Neurol. – 2019. – № 10. – Р. 506. doi: 10.3389/fneur.2019.00506.
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20. Crawshaw A.A., Cock H.R. Medical management of status epilepticus: Emergency room to intensive care unit // Seizure. – 2020. – № 75. – Р. 145-152. doi: 10.1016/j.seizure.2019.10.006.
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22. McTague A. et al. Drug management for acute tonic-clonic convulsions including convulsive status epilepticus in children // Cochrane Database Syst Rev. – 2018. – №1. – Р. CD001905. doi: 10.1002/14651858.CD001905.pub3.
23. McKenzie K.C. et al. Emergency management of the paediatric patient with convulsive status epilepticus // Paediatr Child Health. – 2021. – № 26. – Р. 50–57. doi: 10.1093/pch/pxaa127.
24. Singh K. et al. IV levetiracetam versus IV phenytoin in childhood seizures: a randomized controlled trial // J Pediatr Neurosci. – 2018. – № 13. – Р. 158–164. doi: 10.4103/JPN.JPN_126_17.
25. Zhao Z. et al. A comparison of midazolam, lorazepam, and diazepam for the treatment of status epilepticus in children: a network meta-analysis // J Child Neurol. – 2016. – V. 31. – P. 1093–1107. doi: 10.1177/0883073816638757.
26. Alansari K. et al. Intramuscular versus buccal midazolam for pediatric seizures: a randomized double-blinded trial // Pediatr Neurol. – 2020. – № 109. – Р. 28–34. doi: 10.1016/j.pediatrneurol.2020.03.011.
27. Arya R. et al. Intranasal versus intravenous lorazepam for control of acute seizures in children: a randomized open-label study // Epilepsia. – 2011. – № 52. – Р. 788–793. doi: 10.1111/j.1528-1167.2010.02949.x.
28. Ku L.C. et al. Population Pharmacokinetics and Exploratory Exposure‐Response Relationships of Diazepam in Children Treated for Status Epilepticus // CPT Pharmacometrics Syst Pharmacol. – 2018. – V. 7. – № 11. –Р. 718–727. doi: 10.1002/psp4.12349.
29. Mahmoudian T., Zadeh M.M. Comparison of intranasal midazolam with intravenous diazepam for treating acute seizures in children // Epilepsy Behav. – 2004. – V. 5. – № 2. – Р. 253-255. doi: 10.1016/j.yebeh.2004.01.003.
30. Scott R.C. et al. Buccal midazolam and rectal diazepam for treatment of prolonged seizures in childhood and adolescence: a randomised trial // Lancet. – 1999. – V. 353. – № 9153. – Р. 623-626. doi: 10.1016/S0140-6736(98)06425-3.
31. Chamberlain J.M. et al. Pediatric Emergency Care Applied Research Network (PECARN). Lorazepam vs diazepam for pediatric status epilepticus: a randomized clinical trial // JAMA. – 2014. – № 311. – Р. 1652–1660. doi: 10.1001/jama.2014.2625.
32. Gomes D. al. Consensus protocol for the treatment of super-refractory status epilepticus // Acta Med Port. – 2018. – V. 31. – №10. – Р. 598–605. doi: 10.20344/amp.9679.
33. Yasiry Z., Shorvon S.D. The relative effectiveness of five antiepileptic drugs in treatment of benzodiazepine-resistant convulsive status epilepticus: a meta-analysis of published studies // Seizure. – 2014. – V. 23. – №3. – Р. 167–174. doi: 10.1016/j.seizure.2013.12.007.
34. Lyttle M.D. et al. Levetiracetam versus phenytoin for second-line treatment of paediatric convulsive status epilepticus (EcLiPSE): a multicentre, open-label, randomised trial // Lancet. – 2019. – V. 393. – № 10186. – Р. 2125–2134. doi: 10.1016/S0140-6736(19)30724-X.
35. Dalziel S.R. et al. Levetiracetam versus phenytoin for second-line treatment of convulsive status epilepticus in children (ConSEPT): an open-label, multicentre, randomised controlled trial // Lancet. – 2019. – № 393. – Р. 2135–2145. doi: 10.1016/S0140-6736(19)30722-6.
36. Chamberlain J.M. et al. Efficacy of levetiracetam, fosphenytoin, and valproate for established status epilepticus by age group (ESETT): a double blind, response -adaptive, randomised controlled trial // Lancet. – 2020. – № 395. – Р. 1217–1224. doi: 10.1016/S0140-6736(20)30611-5.
37. Appleton R.E. et al. Levetiracetam as an alternative to phenytoin for second-line emergency treatment of children with convulsive status epilepticus: the EcLiPSE RCT // Health Technol Assess. – 2020. – V. 24. – № 58. – Р. 1-96. doi: 10.3310/hta24580.
38. Yu K.T. Et al. Safety and efficacy of intravenous valproate in pediatric status epilepticus and acute repetitive seizures // Epilepsia. – 2003. – V. 44. – № 5. – Р. 724–726. doi: 10.1046/j.1528-1157.2003.41302.x.
39. Malamiri R.A. et al. Efficacy and safety of intravenous sodium valproate versus phenobarbital in controlling convulsive status epilepticus and acute prolonged convulsive seizures in children: a randomised trial // Eur J Paediatr Neurol. – 2012. – V. 16. – № 5. – Р. 536–541. doi: 10.1016/j.ejpn.2012.01.012.
40. Tanabe T. et al. Management of and prophylaxis against status epilepticus in children with severe myoclonic epilepsy in infancy (SMEI; Dravet syndrome) – a nationwide questionnaire survey in Japan // Brain Dev. – 2008. – № 30. – Р. 629–635. doi: 10.1016/j.braindev.2008.03.002.
41. Poddar K. et al. Intravenous lacosamide in pediatric status epilepticus: an open-label efficacy and safety study // Pediatr Neurol. – 2016. – V. 61. – P. 83–86. doi: 10.1016/j.pediatrneurol.2016.03.021.
42. Strzelczyk A. et al. Lacosamide in status epilepticus: systematic review of current evidence // Epilepsia. – 2017. – № 58. – Р. 933–950. doi: 10.1111/epi.13716.
43. Ozdemir D. et al. Efficacy of continuous midazolam infusion and mortality in childhood refractory generalized convulsive status epilepticus // Seizure. –2005. – V. 14. – № 2. – Р. 129–132. doi: 10.1016/j.seizure.2004.12.005.
44. van Gestel J.P. et al. Propofol and thiopental for refractory status epilepticus in children // Neurology. – 2005. – V. 65. – № 4. – Р. 591-592. doi: 10.1212/01.wnl.0000173066.89001.f9.
45. Gaspard N. et al. Intravenous ketamine for the treatment of refractory status epilepticus: a retrospective multicenter study // Epilepsia. – 2013. – V. 54. – № 8. – Р. 1498–1503. doi: 10.1111/epi.12247.
46. Zeiler F.A. et al. Modern inhalational anesthetics for refractory status epilepticus // Can J Neurol Sci. – 2015. – V. 42. – № 2. – Р. 106–115. doi: 10.1017/cjn.2014.121.
47. Aroor S. et al. Super-refractory status epilepticus: A therapeutic challenge in paediatrics // J. Clin. Diagn. Res. – 2017. – № 11. – Р. SR01–SR04. doi: 10.7860/JCDR/2017/25811.10485.
48. Shorvon S., Ferlisi M. The treatment of super-refractory status epilepticus: A critical review of available therapies and a clinical treatment protocol // Brain. – 2011. – № 134. – Р. 2082–2818. doi: 10.1093/brain/awr215.
2. Becker L.L. et al. Treatment of pediatric convulsive status epilepticus // Front Neurol. – 2023. – № 14. – Р. 1175370. doi: 10.3389/fneur.2023.1175370.
3. Aulická Š. Current Management of Generalized Convulsive Status Epilepticus in Children // Children (Basel). – 2022. – V.9. – № 10. –Р. 1586. doi: 10.3390/children9101586.
4. Messahel S. et al. Optimal Management of Status Epilepticus in Children in the Emergency Setting: A Review of Recent Advances // Open Access Emerg Med. – 2022. – № 14. – Р. 491-506. doi: 10.2147/OAEM.S293258.
5. Schubert-Bast S. et al. Burden and epidemiology of status epilepticus in infants, children, and adolescents: a population-based study on German health insurance data // Epilepsia. – 2019. – V. 60. – P. 911–920. doi: 10.1111/epi.14729.
6. Trinka E et al. A definition and classification of status epilepticus-Report of the ILAE Task Force on Classification of Status Epilepticus // Epilepsia. –2015. – V. 56. – № 10. – Р. 1515-1523. doi: 10.1111/epi.13121.
7. Trinka E., Kalviainen R. 25 years of advances in the definition, classification and treatment of status epilepticus // Seizure. – 2017. – № 44. – Р. 65–73. doi: 10.1016/j.seizure.2016.11.001.
8. Ong C.T. et al. Underestimated rate of status epilepticus according to the traditional definition of status epilepticus // Scientific World Journal. – 2015. – № 2015. – Р. 801834. doi: 10.1155/2015/801834.
9. Soto-Insuga V. et al. [Paediatric status epilepticus]. [Article in Spanish] // Rev Neurol. – 2022. – V. 75. – № 8. – Р. 225-238. doi: 10.33588/rn.7508.2022196.
10. Bergonzini L. et al. Status Epilepticus in Chromosomal Disorders Associated with Epilepsy: A Systematic Review // Genes (Basel). – 2023. – V. 14. – № 2. –Р. 299. doi: 10.3390/genes14020299.
11. Meyer S. et al. Epileptic Status in a PEDiatric cohort (ESPED) requiring intensive care treatment: A multicenter, national, two-year prospective surveillance study // Epilepsia Open. – 2023. – V. 8. – № 2. – Р. 411-424. doi: 10.1002/epi4.12707.
12. Stredny C.M. et al. Towards acute pediatric status epilepticus intervention teams: do we need “Seizure Codes”? // Seizure. – 2018. – № 58. – Р. 133–140. doi: 10.1016/j.seizure.2018.04.011.
13. Pujar S.S. et al. Long‐term prognosis after childhood convulsive status epilepticus: a prospective cohort study // Lancet Child Adolesc Health. – 2018. – № 2. – Р. 103–111. doi: 10.1016/S2352-4642(17)30174-8.
14. Amengual-Gual M. et al. Novel drugs and early polypharmacotherapy in status epilepticus // Seizure. – 2019. – № 68. – Р. 79-88. doi: 10.1016/j.seizure.2018.08.004.
15. Sanchez Fernandez I. et al. Pathophysiology of convulsive status epilepticus // Seizure. – 2019. – 68. – P. 16–21. doi: 10.1016/j.seizure.2018.08.002.
16. Walker M.C. Pathophysiology of Status Epilepticus // Neurosci Lett. – 2018. –№ 22. – Р. 84-91. doi: 10.1016/j.neulet.2016.12.044.
17. Burman R.J. et al. A comparison of parenteral phenobarbital vs. parenteral phenytoin as second-line management for pediatric convulsive status epilepticus in a resource-limited setting // Front Neurol. – 2019. – № 10. – Р. 506. doi: 10.3389/fneur.2019.00506.
18. Brophy G.M. et al. Guidelines for the evaluation and management of status epilepticus // Neurocrit Care. – 2012. – V. 17. – №1. – Р. 3–23. doi: 10.1007/s12028-012-9695-z.
19. Glauser T. et al. Evidence-based guideline: treatment of convulsive status epilepticus in children and adults: report of the guideline committee of the American Epilepsy Society // Epilepsy Curr. – 2016. – V. 16. – P. 48–61. doi: 10.5698/1535-7597-16.1.48.
20. Crawshaw A.A., Cock H.R. Medical management of status epilepticus: Emergency room to intensive care unit // Seizure. – 2020. – № 75. – Р. 145-152. doi: 10.1016/j.seizure.2019.10.006.
21. Lawton B. et al. An update in the initial management of paediatric status epilepticus // Curr Opin Pediatr. – 2018. – V. 30. – №3. – Р. 359–363. doi: 10.1097/MOP.0000000000000616.
22. McTague A. et al. Drug management for acute tonic-clonic convulsions including convulsive status epilepticus in children // Cochrane Database Syst Rev. – 2018. – №1. – Р. CD001905. doi: 10.1002/14651858.CD001905.pub3.
23. McKenzie K.C. et al. Emergency management of the paediatric patient with convulsive status epilepticus // Paediatr Child Health. – 2021. – № 26. – Р. 50–57. doi: 10.1093/pch/pxaa127.
24. Singh K. et al. IV levetiracetam versus IV phenytoin in childhood seizures: a randomized controlled trial // J Pediatr Neurosci. – 2018. – № 13. – Р. 158–164. doi: 10.4103/JPN.JPN_126_17.
25. Zhao Z. et al. A comparison of midazolam, lorazepam, and diazepam for the treatment of status epilepticus in children: a network meta-analysis // J Child Neurol. – 2016. – V. 31. – P. 1093–1107. doi: 10.1177/0883073816638757.
26. Alansari K. et al. Intramuscular versus buccal midazolam for pediatric seizures: a randomized double-blinded trial // Pediatr Neurol. – 2020. – № 109. – Р. 28–34. doi: 10.1016/j.pediatrneurol.2020.03.011.
27. Arya R. et al. Intranasal versus intravenous lorazepam for control of acute seizures in children: a randomized open-label study // Epilepsia. – 2011. – № 52. – Р. 788–793. doi: 10.1111/j.1528-1167.2010.02949.x.
28. Ku L.C. et al. Population Pharmacokinetics and Exploratory Exposure‐Response Relationships of Diazepam in Children Treated for Status Epilepticus // CPT Pharmacometrics Syst Pharmacol. – 2018. – V. 7. – № 11. –Р. 718–727. doi: 10.1002/psp4.12349.
29. Mahmoudian T., Zadeh M.M. Comparison of intranasal midazolam with intravenous diazepam for treating acute seizures in children // Epilepsy Behav. – 2004. – V. 5. – № 2. – Р. 253-255. doi: 10.1016/j.yebeh.2004.01.003.
30. Scott R.C. et al. Buccal midazolam and rectal diazepam for treatment of prolonged seizures in childhood and adolescence: a randomised trial // Lancet. – 1999. – V. 353. – № 9153. – Р. 623-626. doi: 10.1016/S0140-6736(98)06425-3.
31. Chamberlain J.M. et al. Pediatric Emergency Care Applied Research Network (PECARN). Lorazepam vs diazepam for pediatric status epilepticus: a randomized clinical trial // JAMA. – 2014. – № 311. – Р. 1652–1660. doi: 10.1001/jama.2014.2625.
32. Gomes D. al. Consensus protocol for the treatment of super-refractory status epilepticus // Acta Med Port. – 2018. – V. 31. – №10. – Р. 598–605. doi: 10.20344/amp.9679.
33. Yasiry Z., Shorvon S.D. The relative effectiveness of five antiepileptic drugs in treatment of benzodiazepine-resistant convulsive status epilepticus: a meta-analysis of published studies // Seizure. – 2014. – V. 23. – №3. – Р. 167–174. doi: 10.1016/j.seizure.2013.12.007.
34. Lyttle M.D. et al. Levetiracetam versus phenytoin for second-line treatment of paediatric convulsive status epilepticus (EcLiPSE): a multicentre, open-label, randomised trial // Lancet. – 2019. – V. 393. – № 10186. – Р. 2125–2134. doi: 10.1016/S0140-6736(19)30724-X.
35. Dalziel S.R. et al. Levetiracetam versus phenytoin for second-line treatment of convulsive status epilepticus in children (ConSEPT): an open-label, multicentre, randomised controlled trial // Lancet. – 2019. – № 393. – Р. 2135–2145. doi: 10.1016/S0140-6736(19)30722-6.
36. Chamberlain J.M. et al. Efficacy of levetiracetam, fosphenytoin, and valproate for established status epilepticus by age group (ESETT): a double blind, response -adaptive, randomised controlled trial // Lancet. – 2020. – № 395. – Р. 1217–1224. doi: 10.1016/S0140-6736(20)30611-5.
37. Appleton R.E. et al. Levetiracetam as an alternative to phenytoin for second-line emergency treatment of children with convulsive status epilepticus: the EcLiPSE RCT // Health Technol Assess. – 2020. – V. 24. – № 58. – Р. 1-96. doi: 10.3310/hta24580.
38. Yu K.T. Et al. Safety and efficacy of intravenous valproate in pediatric status epilepticus and acute repetitive seizures // Epilepsia. – 2003. – V. 44. – № 5. – Р. 724–726. doi: 10.1046/j.1528-1157.2003.41302.x.
39. Malamiri R.A. et al. Efficacy and safety of intravenous sodium valproate versus phenobarbital in controlling convulsive status epilepticus and acute prolonged convulsive seizures in children: a randomised trial // Eur J Paediatr Neurol. – 2012. – V. 16. – № 5. – Р. 536–541. doi: 10.1016/j.ejpn.2012.01.012.
40. Tanabe T. et al. Management of and prophylaxis against status epilepticus in children with severe myoclonic epilepsy in infancy (SMEI; Dravet syndrome) – a nationwide questionnaire survey in Japan // Brain Dev. – 2008. – № 30. – Р. 629–635. doi: 10.1016/j.braindev.2008.03.002.
41. Poddar K. et al. Intravenous lacosamide in pediatric status epilepticus: an open-label efficacy and safety study // Pediatr Neurol. – 2016. – V. 61. – P. 83–86. doi: 10.1016/j.pediatrneurol.2016.03.021.
42. Strzelczyk A. et al. Lacosamide in status epilepticus: systematic review of current evidence // Epilepsia. – 2017. – № 58. – Р. 933–950. doi: 10.1111/epi.13716.
43. Ozdemir D. et al. Efficacy of continuous midazolam infusion and mortality in childhood refractory generalized convulsive status epilepticus // Seizure. –2005. – V. 14. – № 2. – Р. 129–132. doi: 10.1016/j.seizure.2004.12.005.
44. van Gestel J.P. et al. Propofol and thiopental for refractory status epilepticus in children // Neurology. – 2005. – V. 65. – № 4. – Р. 591-592. doi: 10.1212/01.wnl.0000173066.89001.f9.
45. Gaspard N. et al. Intravenous ketamine for the treatment of refractory status epilepticus: a retrospective multicenter study // Epilepsia. – 2013. – V. 54. – № 8. – Р. 1498–1503. doi: 10.1111/epi.12247.
46. Zeiler F.A. et al. Modern inhalational anesthetics for refractory status epilepticus // Can J Neurol Sci. – 2015. – V. 42. – № 2. – Р. 106–115. doi: 10.1017/cjn.2014.121.
47. Aroor S. et al. Super-refractory status epilepticus: A therapeutic challenge in paediatrics // J. Clin. Diagn. Res. – 2017. – № 11. – Р. SR01–SR04. doi: 10.7860/JCDR/2017/25811.10485.
48. Shorvon S., Ferlisi M. The treatment of super-refractory status epilepticus: A critical review of available therapies and a clinical treatment protocol // Brain. – 2011. – № 134. – Р. 2082–2818. doi: 10.1093/brain/awr215.