BRAIN and NERVE－神経研究の進歩67巻5号

2015年05月発行

特集 NCSE（非痙攣性てんかん重積状態）

非痙攣性てんかん重積状態に関する諸問題—臨床と研究の進歩

著者： 永山正雄¹ 梁成勲¹

所属機関： ¹国際医療福祉大学熱海病院神経内科，脳卒中・神経センター

ページ範囲：P.553 - P.562

文献概要

本稿では，非痙攣性てんかん重積状態（NCSE）の臨床，研究上の重要な諸問題として，脳波異常の範疇，antiepileptic drug-responsive neurological deficit（ADND），malignant and critical NCSE，てんかん関連臓器機能障害（Epi-ROD），リアルタイム・ニューロモニタリング，脳神経系包括的評価スコアNeurocritical Score（Inte-grated Scale）などを取り上げ，best available evidenceを踏まえて最近の進歩をまとめる。

参考文献

1) 永山正雄: 非痙攣性てんかん重積状態の臨床と病態. Brain Nerve 65: 561-572, 2013

2) Proposal for revised clinical and electroencephalographic classification of epileptic seizures. From the Commission on Classification and Terminology of the International League Against Epilepsy. Epilepsia 22: 489-501, 1981

3) Brophy GM, Bell R, Claassen J, Alldredge B, Bleck TP, et al: Neurocritical Care Society Status Epilepticus Guideline Writing Committee. Guidelines for the evaluation and management of status epilepticus. Neurocrit Care 17: 3-23, 2012

4) Rossetti AO, Logroscino G, Bromfield EB: Refractory status epilepticus: effect of treatment aggressiveness on prognosis. Arch Neurol 62: 1698-1702, 2005

5) Kaplan PW, Drislane FW (eds): Nonconvulsive status epilepticus. Demos Medical Publishing, New York, 2008

6) 永山正雄, 梁　成勲, 北川恒実, 清水利充, 塩澤全司, 他: Rendu-Osler-Weber病の経過中に高NH3血症性脳症を合併し, 非痙攣性てんかん重積状態を呈した84歳女性例（抄). 臨床神経53: 255, 2013

7) Kaplan PW, Schlattman DK: Comparison of triphasic waves and epileptic discharges in one patient with genetic epilepsy. J Clin Neurophysiol 29: 458-461, 2012

8) Nagayama M, Matsushima K, Nagayama T, Shinohara Y: Persistent but reversible coma in encephalitis. Neurocritical Care 2: 252-257, 2005

9) Fernández-Torre JL, Kaplan PW, Rebollo M, Gutiérrez A, Hernández-Hernández MA, et al: Ambulatory non-convulsive status epilepticus evolving into a malignant form. Epileptic Disord 14: 41-50, 2012

10) 梁　成勲, 永山正雄: てんかん重積状態（NCSEを中心に). 日本神経救急学会雑誌27, 2015 (in press)

11) Bleck TP, Smith MC, Pierre-Louis SJ, Jares JJ, Murray J, et al: Neurologic complications of critical medical illnesses. Crit Care Med 21: 98-103, 1993

12) 永山正雄: 神経救急診療総括. 橋本信夫（監). 清水宏明（編): 脳神経外科診療プラクティス4．文光堂, 東京, 2014

13) 永山正雄: 「過換気後遷延性無呼吸」と自律神経発作—非痙攣性てんかん重積状態の新たな表現型—. 神経内科71: 232-236, 2009

14) Terra VC, Cysneiros R, Cavalheiro EA, Scorza FA: Sudden unexpected death in epilepsy: from the lab to the clinic setting. Epilepsy Behav 26: 415-420, 2013

15) Nashef L, So EL, Ryvlin P, Tomson T: Unifying the definitions of sudden unexpected death in epilepsy. Epilepsia 53: 227-233, 2012

16) Devinsky O: Sudden, unexpected death in epilepsy. N Engl J Med 365: 1801-1811, 2011

17) Duncan JS, Sander JW, Sisodiya SM, Walker MC: Adult epilepsy. Lancet 367: 1087-1100, 2006

18) Cole AJ, Eskandar E, Mela T, Noebels JL, Gonzalez RG, et al: Case records of the Massachusetts General Hospital. Case 18-2013: a 32-year-old woman with recurrent episodes of altered consciousness. N Engl J Med 368: 2304-2312, 2013

19) Ryvlin P, Nashef L, Lhatoo SD, Bateman LM, Bird J, et al: Incidence and mechanisms of cardiorespiratory arrests in epilepsy monitoring units (MORTEMUS): a retrospective study. Lancet Neurol 12: 966-977, 2013

20) Nagayama M: F1000Prime Recommendation of ［Ryvlin P et al., Lancet Neurol 2013, 12(10):966-77］. F1000Prime, 17 Dec 2013 doi: 10.3410/f.718102172.793488123．F1000Prime.com/718102172#eval793488123

21) 永山正雄: 非痙攣性てんかん重積状態とは何ですか. 河村　満（編): 高次脳機能障害Q＆A基礎編. 新興医学出版社, 東京. 2011, pp190-192

22) Sugimoto A, Futamura A, Ishigaki S, Hieda S, Miller MW, et al: Successful use of anti-epileptic drugs in three cases of epilepsy with higher brain dysfunction Neurology and Clinical Neuroscience 1: 18-23, 2013

23) Le Roux P, Menon DK, Citerio G, Vespa P, Bader MK, et al: Consensus Summary Statement of the International Multidisciplinary Consensus Conference on Multimodality Monitoring in Neurocritical Care: A statement for healthcare professionals from the Neurocritical Care Society and the European Society of Intensive Care Medicine. Neurocrit Care 2014 Sep 11 ［Epub ahead of print］

24) Nagayama M: F1000Prime Recommendation of ［Le Roux P et al., Neurocrit Care 2014］. F1000Prime, 05 Mar 2015 doi: 10.3410/f.718872155.793504565．F1000Prime.com/718872155#eval793504565