Hypoxemia Following Generalized Convulsive Seizures: Risk Factors and Effect of Oxygen Therapy Rheims S, Alvarez BM, Alexandre V, Curot J, Maillard L, Bartolomei F, et al; the REPO2MSE Study Group. Hypoxemia following generalized convulsive seizures: risk factors and effect of oxygen therapy . Neurology. 2019;92(3):e183-e193 Objective: To analyze the factors that determine the occurrence or severity of postictal hypoxemia in the immediate aftermath of a generalized convulsive seizure (GCS). METHODS We reviewed the video-electroencephalogram (EEG) recordings of 1006 patients with drug-resistant focal epilepsy included in the REPO2MSE study to identify those with ≥1 GCS and pulse oximetry (SpO2) measurement. Factors determining recovery of SpO2 ≥90% were investigated using Cox proportional hazards models. Association between SpO2 nadir and person- or seizure-specific variables was analyzed after correction for individual effects and the varying number of seizures. RESULTS A total of 107 GCS in 73 patients were analyzed. A transient hypoxemia was observed in 92 (86%) GCS. Rate of GCS with SpO2 <70% dropped from 40% to 21% when oxygen was administered early ( P = .046). Early recovery of SpO2 ≥90% was associated with early administration of oxygen ( P = .004), absence of postictal generalized EEG suppression (PGES; P = .014), and extratemporal lobe epilepsy ( P = .001). Lack of early administration of O2 ( P = .003), occurrence of PGES ( P = .018), and occurrence of ictal hypoxemia during the focal phase ( P = .022) were associated with lower SpO2 nadir. CONCLUSION Postictal hypoxemia was observed in the immediate aftermath of nearly all GCS, but administration of oxygen had a strong preventive effect. Severity of postictal hypoxemia was greater in temporal lobe epilepsy and when hypoxemia was already observed before the onset of secondary GCS.

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不要只是站在那儿：做点什么！围手术期的情况。

全身性抽搐发作后的低氧血症：危险因素和氧气疗法的作用Rheims S，Alvarez BM，Alexandre V，Curot J，Maillard L，Bartolomei F等；REPO2MSE研究小组。全身性惊厥发作后的低氧血症：危险因素和氧气疗法的影响。神经病学。2019; 92（3）：e183-e193目的：分析确定广泛性惊厥性癫痫发作（GCS）即时发生后低氧血症发生或严重程度的因素。方法我们回顾了REPO2MSE研究中包括的1006例耐药性局灶性癫痫患者的视频脑电图（EEG）记录，以识别≥1 GCS和脉搏血氧饱和度（SpO2）测量的患者。使用Cox比例风险模型研究了确定SpO2≥90％回收率的因素。在校正个体影响和癫痫发作次数变化后，分析了SpO2最低点和特定于个人或癫痫发作的变量之间的关联。结果对73例患者的107个GCS进行了分析。在92（86％）GCS中观察到短暂性低氧血症。当早期给予氧气时，SpO2 <70％的GCS的比例从40％降至21％（P = .046）。SpO2≥90％的早期恢复与早期给予氧气有关（P = .004），缺乏术后全身性EEG抑制（PGES; P = .014）和颞叶癫痫（P = .001）。缺乏氧的早期给药（P = .003），PGES的发生（P = .018）和在局灶期出现缺氧性低氧血症（P = .022）与SpO2最低点有关。结论几乎所有GCS发生后都发生了邮政低氧血症，但是吸氧有很强的预防作用。颞叶癫痫发作以及继发于GCS发作之前已经观察到低氧血症时，邮政低氧血症的严重程度更高。