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タナカ リョウジロウ
Ryojiro Tanaka
田中 亮二郎 所属 川崎医科大学 医学部 臨床医学 小児科学 職種 特任教授 |
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| 論文種別 | 原著 |
| 言語種別 | 英語 |
| 査読の有無 | 査読あり |
| 表題 | Prognostic effects of treatment protocols for febrile convulsive status epilepticus in children. |
| 掲載誌名 | 正式名：BMC neurology 略 称：BMC Neurol ISSNコード：14712377/14712377 |
| 掲載区分 | 国外 |
| 巻・号・頁 | 22(1),pp.77 |
| 著者・共著者 | Shoichi Tokumoto, Masahiro Nishiyama, Hiroshi Yamaguchi, Kazumi Tomioka, Yusuke Ishida, Daisaku Toyoshima, Hiroshi Kurosawa, Kandai Nozu, Azusa Maruyama, Ryojiro Tanaka, Kazumoto Iijima, Hiroaki Nagase |
| 発行年月 | 2022/03 |
| 概要 | BACKGROUND:Febrile status epilepticus is the most common form of status epilepticus in children. No previous reports compare the effectiveness of treatment strategies using fosphenytoin (fPHT) or phenobarbital (PB) and those using anesthetics as second-line anti-seizure medication for benzodiazepine-resistant convulsive status epilepticus (CSE). We aimed to examine the outcomes of various treatment strategies for febrile convulsive status epilepticus (FCSE) in a real-world setting while comparing the effects of different treatment protocols and their presence or absence.METHODS:This was a single-center historical cohort study that was divided into three periods. Patients who presented with febrile convulsive status epilepticus for ≥60 min even after the administration of at least one anticonvulsant were included. During period I (October 2002-December 2006), treatment was performed at the discretion of the attending physician, without a protocol. During period II (January 2007-February 2013), barbiturate coma therapy (BCT) was indicated for FCSE resistant to benzodiazepines. During period III (March 2013-April 2016), BCT was indicated for FCSE resistant to fPHT or PB.RESULTS:The rate of electroencephalogram monitoring was lower in period I than period II+III (11.5% vs. 85.7%, p<0.01). Midazolam was administered by continuous infusion more often in period I than period II+III (84.6% vs. 25.0%, p<0.01), whereas fPHT was administered less often in period I than period II+III (0% vs. 27.4%, p<0.01). The rate of poor outcome, which was determined using the Pediatric Cerebral Performance Category scale, was higher in period I than period II+III (23.1% vs. 7.1%, p=0.03). The rate of poor outcome did not differ between periods II and III (4.2% vs. 11.1%, p=0.40).CONCLUSIONS:While the presence of a treatment protocol for FCSE in children may improve outcomes, a treatment protocol using fPHT or PB may not be associated with better outcomes. |
| DOI | 10.1186/s12883-022-02608-2 |
| PMID | 35247987 |