けいれん性てんかん重積と非けいれん性てんかん重積

Status Epilepticus: Convulsive and Nonconvulsive

Point

・てんかん重積にはけいれん性と非けいれん性があり，救急の現場では特に高齢者での非けいれん性てんかん重積を念頭に置く必要がある．

・てんかん重積の診断は容易ではない場合もあるが，症状や脳波から迅速に行わなければならない．

・てんかん重積の治療は第一段階から順に行うが，迅速に症状が改善しない場合には神経機能障害が残存する可能性がある．

　Status epilepticus（SE）is common, particularly among neurological emergency physicians. SE includes convulsive SE（CSE）and nonconvulsive SE（NCSE）. Recently, the number of elderly patients with status epilepticus has increased. Most patients were diagnosed with NCSE. Prolonged SE often impairs neuronal function and is sometimes life threatening. Prompt diagnosis of SE and treatment initiation are essential for good outcomes. However, an accurate diagnosis of NCSE is difficult because the clinical symptoms of NCSE may vary, and electroencephalography may show various characteristics. Recent advances in the diagnosis and treatment of SE have been reported, particularly with regard to electroencephalography（EEG）and newly available drugs.