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神经系统疾病外科患者的围手术期处理

Authors
Geno J Merli, MD, FACP, FHM
Rodney D Bell, MD
Section Editor
Michael J Aminoff, MD, DSc
Deputy Editors
Janet L Wilterdink, MD
Marianna Crowley, MD
Translators
海舰, 主任医师，教授

引言

对医学顾问而言，神经系统疾病患者的围手术期处理是一个挑战。最重要的考虑是用于治疗神经系统疾病的药物处理、对这类疾病的病理生理机制的认识及对围手术期新出现的神经系统改变的评估。较常见的神经系统疾病及其围手术期处理总结在此。

癫痫发作性疾病

在美国至少有1百万人有反复的癫痫发作或有癫痫[1]。大多数癫痫患者采用抗癫痫药(antiepileptic drug, AED)治疗。(参见“成人癫痫处理概述”)

癫痫患者的术后并发症风险似乎较大，这一部分是由于癫痫，一部分是由于癫痫相关的共病。一项回顾性数据库研究显示：与无癫痫的个体相比，13,103例癫痫患者术后并发症的发生率更高(OR 2)[2]。癫痫患者最显著的术后并发症被认为是脑卒中。

围手术期患者癫痫发作的原因 — 围手术期癫痫发作的原因有多种，包括：

●麻醉

                       

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Literature review current through: 2017-06 . | This topic last updated: 2014-09-10.
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