Status epilepticus causes prolonged or repetitive seizures that, if left untreated, can lead to neuronal injury, severe disability, coma and death in paediatric and adult populations. While convulsive status epilepticus can be diagnosed using clinical features alone, non-convulsive status epilepticus requires confirmation by electroencephalogram. Early seizure control remains key in preventing the complications of status epilepticus. This is especially true for convulsive status epilepticus, which has stronger evidence supporting the benefit of treatment on outcomes. When status epilepticus becomes refractory, often due to gamma-aminobutyric acid and N-methyl-D-aspartate receptor modulation, anaesthetic drugs are needed to suppress seizure activity, of which there is limited evidence regarding the selection, dose or duration of their use. Seizure monitoring with electroencephalogram is often needed when patients do not return to baseline or during anaesthetic wean; however, it is resource-intensive, costly, only available in highly specialised centres and has not been shown to improve functional outcomes. Thus, the treatment goals and aggressiveness of therapy remain under debate, especially for non-convulsive status epilepticus, where prolonged therapeutic coma can lead to severe complications. This review presents an evidence-based, clinically-oriented and comprehensive review of status epilepticus and its definitions, aetiologies, treatments, outcomes and prognosis at different stages of the patient's journey.

中文翻译：

---

癫痫持续状态的管理：叙述性回顾。

癫痫持续状态会导致长时间或重复性癫痫发作，如果不及时治疗，可能导致儿科和成人的神经元损伤、严重残疾、昏迷和死亡。虽然仅使用临床特征可以诊断惊厥性癫痫持续状态，但非惊厥性癫痫持续状态需要通过脑电图确认。早期控制癫痫发作仍然是预防癫痫持续状态并发症的关键。对于惊厥性癫痫持续状态尤其如此，它有更强有力的证据支持治疗对结果的益处。当癫痫持续状态变得难治时，通常是由于 γ-氨基丁酸和 N-甲基-D-天冬氨酸受体的调节，需要麻醉药物来抑制癫痫发作活动，其中关于其使用的选择、剂量或持续时间的证据有限。当患者未恢复到基线或麻醉撤机期间，通常需要使用脑电图监测癫痫发作；然而，它是资源密集型的、成本高昂的，只能在高度专业化的中心使用，并且没有被证明可以改善功能结果。因此，治疗目标和治疗的积极性仍然存在争议，特别是对于非惊厥性癫痫持续状态，长期治疗昏迷可导致严重并发症。本综述对癫痫持续状态及其定义、病因、治疗、结果和预后在患者旅程的不同阶段进行了循证、临床导向和全面的综述。仅在高度专业化的中心可用，并且未显示可改善功能结果。因此，治疗目标和治疗的积极性仍然存在争议，特别是对于非惊厥性癫痫持续状态，长期治疗昏迷可导致严重并发症。本综述对癫痫持续状态及其定义、病因、治疗、结果和预后在患者旅程的不同阶段进行了循证、临床导向和全面的综述。仅在高度专业化的中心可用，并且未显示可改善功能结果。因此，治疗目标和治疗的积极性仍然存在争议，特别是对于非惊厥性癫痫持续状态，长期治疗昏迷可导致严重并发症。本综述对癫痫持续状态及其定义、病因、治疗、结果和预后在患者旅程的不同阶段进行了循证、临床导向和全面的综述。