右美托咪啶治疗间脑发作一例

One case with Dexmedetomidine for diencephalic epilepsy

间脑发作,又称阵发性交感神经过度兴奋,是一种以阵发性高热、高血压、心动过速、呼吸急促伴大汗、肌张力障碍等自主神经功能紊乱为主要临床表现的临床综合征,因其临床表现与癫痫类似常被误诊,加之目前临床医师对其认识不足,诊断率较低.间脑发作多发生于颅脑损伤后,其中创伤性脑损伤后多见,其次为脑缺氧、脑卒中后.间脑发作时采取镇静、抗癫痫治疗在止抽搐方面常有满意效果,但是不能完全改善交感兴奋.右美托咪定具有镇静、镇痛、解交感作用,本文首次以右美托咪定为主治疗昏迷患者间脑发作,治疗效果好,并脑复苏成功.

Mesencephalic seizure, also known as paroxysmal sympathetic hyperexcitability, is a kind of clinical syndrome which mainly manifested as paroxysmal high fever, hypertension, tachycardia, shortness of breath accompanied by sweating, dystonia and other autonomic nervous dysfunction. As the clinical manifestations are similar to epilepsy, mesencephalic seizure is often misdiagnosed by clinical doctors. Diencephalon attack usually occurs after craniocerebral injury, especially traumatic brain injury, followed by cerebral hypoxia and stroke. Sedative and anti-epileptic treatment during mesencephalic seizures can get satisfactory effects but can not completely improve sympathetic excitation. Dexmedetomidine has sedative, analgesic, sympathetic relief effect. We here first report a successful mesencephalic seizures case who received the Dexmedetomidine as main treatment.