Ms. Q, a 29-year-old woman, began to behave strangely, claiming to see and hear imaginary people. The following day, she was confused and somnolent in the morning. In the late morning, she had a generalized tonic-clonic seizure and was transported to the hospital. Her past medical and developmental histories were unremarkable. She took a daily oral contraceptive and had no drug allergies. She worked as a teacher and had been married for one year. On initial examination, blood pressure was 129/82, pulse 88, respiratory rate 16, temperature 37.5 °C. She was stuporous, moving her arms appropriately in response to a painful stimulus. Pupils were 2 mm and reactive. There was no gaze preference, and the rest of the examination was nonfocal. About 30 minutes after her first seizure, she had a second GTCS and was given 4 mg lorazepam intravenously. She had a third GTCS 6 min after her second seizure and received a second dose of lorazepam. Initial blood tests-including complete blood count, comprehensive metabolic panel, urinalysis, and toxic screen-were normal. Head CT was normal. She remained stuporous. EEG demonstrated waxing and waning electrographic ictal activity, and she was loaded with fosphenytoin. Intermittent electrographic seizure activity persisted, and a continuous infusion of intravenous propofol was administered. After 24 hr, propofol was weaned, but electrographic seizures recurred and it was restarted.

中文翻译：

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急性脑炎情况下的癫痫持续状态。

Q 女士，一名 29 岁的女性，开始表现出奇怪的行为，声称能看到和听到想象中的人。第二天早上，她神志不清，昏昏欲睡。当天上午晚些时候，她出现全身性强直阵挛性癫痫，被送往医院。她过去的病史和发育史并不引人注目。她每天服用口服避孕药，没有药物过敏。她是一名教师，结婚一年。初步检查，血压 129/82，脉搏 88，呼吸频率 16，体温 37.5 °C。她昏迷不醒，对疼痛的刺激做出适当的移动。瞳孔为 2 毫米且反应灵敏。没有凝视偏好，其余的检查是非焦点的。第一次癫痫发作后约 30 分钟，她再次出现 GTCS，并静脉注射了 4 毫克劳拉西泮。她在第二次癫痫发作后 6 分钟接受了第三次 GTCS，并接受了第二剂劳拉西泮。最初的血液检查——包括全血细胞计数、综合代谢组、尿液分析和毒性筛查——都正常。头部CT正常。她仍然昏迷不醒。脑电图显示发作时电图活动时好时坏，她服用了磷苯妥英。间歇性电图癫痫活动持续存在，并持续静脉输注丙泊酚。24 小时后，停用丙泊酚，但再次出现电图癫痫发作并重新开始使用。脑电图显示发作时电图活动时好时坏，她服用了磷苯妥英。间歇性电图癫痫活动持续存在，并持续静脉输注丙泊酚。24 小时后，停用丙泊酚，但再次出现电图癫痫发作并重新开始使用。脑电图显示发作时电图活动时好时坏，她服用了磷苯妥英。间歇性电图癫痫活动持续存在，并持续静脉输注丙泊酚。24 小时后，停用丙泊酚，但再次出现电图癫痫发作并重新开始使用。