癲癇的處理management of seizures

癲癇的處理     management of seizures

參考資料:

Glauser, T., Shinnar, S., Gloss, D., Alldredge, B., Arya, R., Bainbridge, J., ... & Treiman, D. M. (2016). Evidence-based guideline: treatment of convulsive status epilepticus in children and adults: report of the Guideline Committee of the American Epilepsy Society. Epilepsy currents, 16(1), 48-61.

 

l   處理程序：

l   比較

n   Midazolam IM比Lorazepam IV如上圖

n   Lorazepam IV 2 mg比Diazepam IV 5 mg

Lorazepam和Diazepam都比對照組好: lorazepam (59.1%) > placebo (21.1%) (OR, 4.8; 95% CI: 1.9–13.0)、diazepam (42.6%) > placebo (21.1%) (OR, 2.3; 95% CI: 1.0–5.9)

Alldredge BK, Gelb AM, Isaacs SM, Corry MD, Allen F, Ulrich S, Gottwald MD, O’Neil N, Neuhaus JM, Segal MR, Lowenstein DH. A comparison of lorazepam, diazepam, and placebo for the treatment of out-of-hospital status epilepticus. N Engl J Med 2001;345:631–637.

n   Lorazepam IV 4 mg比Diazepam IV 10 mg

Lorazepam第一劑成功率78%、第二劑89% ，Diazepam第一劑成功率58%、第二劑76%，兩藥之間並沒有顯著差異。

Leppik IE, Derivan AT, Homan RW, Walker J, Ramsay RE, Patrick B. Double-blind study of lorazepam and diazepam in status epilepticus. JAMA 1983;249:1452–1454.