探讨心肺复苏后非癫痫肌阵挛临床治疗  

Case study： nonepileptic myoclonus post-cardiopulmonary resuscitation （CPR）

作　　者：李振洲[1] 张耀芬[1] 刘燕[1] 张昕[1] 邸颖[1] 

机构地区：[1]中国人民武装警察部队总医院干部病房三科,北京100039

出　　处：《中国急救复苏与灾害医学杂志》2012年第7期628-630,共3页China Journal of Emergency Resuscitation and Disaster Medicine

摘　　要：目的探讨心肺复苏后非癫痫肌阵挛临床表现、发病机制、诊治及预后。方法报道1例心肺复苏后肌阵挛患者的临床治疗，并结合文献报道分析其临床表现、脑电图特征、治疗和预后。结果患者为心肺复苏后昏迷患者，自急性期出现反复持续面部及全身肌肉抽动，肌肉抽动时不伴有脑电图痫样放电。用丙戊酸钠联合氯硝西泮治疗疗效显著。结论心肺复苏后肌阵挛具有多样性。急性期昏迷患者出现非癫痫顽固性肌阵挛可能与大脑皮层广泛性功能障碍和皮层下损害有关，其出现提示预后不良。某些抗癫痫药物治疗有效。Objective To evaluate the clinical symptom, pathogenesis, diagnosis, prognosis of nonepileptic myoclonus after CPR performed. Methods One case of nonepileptic myoclonus after CPR performed was analyzed along with the reviewed literature, the clinical materials, characteristic of EEG, the treatment and the prognosis. Results The patient remained unconscious after CPR performed. Recurrent and persistent muscle jerks of face and whole body had been emerged since the acute stage. The EEG showed no epileptiform discharges time-locked to the jerks. The treatment with sodium valproate plus clouazepam received positive response. Conclusion The myoclonus after CPR performed has various presentation. The nonepileptic myoclonus occurring in the unconscious patient after CPR might be associated with the extensive cortical dysfunction and subcortical damage, which indicated poor outcome. Some antiepileptic drug may be beneficial to the myoclonus.

关 键 词：心肺复苏 非癫痫 肌阵挛 

分 类 号：R605.974[医药卫生—急诊医学]