成人顽固性癫痫持续状态的临床分析  

Clinical analysis of refractory status epilepticus in adults

作　　者：王晓锋[1] 潘速跃[1] 陆兵勋[1] 

机构地区：[1]南方医科大学南方医院神经内科,广州510515

出　　处：《中华神经医学杂志》2007年第7期711-714,共4页Chinese Journal of Neuromedicine

摘　　要：目的探讨成人顽固性癫痫持续状态(RSE)的危险因素、临床特点、治疗及预后。方法54例癫痫持续状态(SE),58次发作事件,分为RSE组和非顽固性癫痫持续状态(NRSE)组,对病因、诱因、临床表现、辅助检查、预后等进行对比分析。结果RSE占SE的43.1%,病毒性脑炎是RSE最主要的病因(P=0.001),相反,既往癫痫发作在NRSE中更常见(P=0.000),相应地药物治疗的改变引起的SE多为NRSE(P=0.003);RSE组GCS评分及预后较NRSE组均差(均P= 0.000)。结论SE经一、二线抗癫痫药治疗后仍有很大一部分难以控制,病毒性脑炎是导致RSE的一个重要病因,其预后较差,目前对RSE的治疗还缺乏十分合理的方案。Objective To investigate the risk factors, clinical features, treatment and prognosis in adult patients with refractory status epilepticus （RSE）. Methods A total of 54 cases of status epilepticus （SE） with 58 onsets hospitalized during October, 1996 and June, 2006 in the Department of Neurology of Nanfang Hospital were divided into RSE group and non-refractory status epilepticus （NRSE） group. A retrospective study was made on these patients to analyze the causes of the disease, inducements, clinical symptoms, assistant examinations and prognoses etc comparatively. Results All the 58 episodes fulfilled the criteria of SE put forward by SE workgroup of the Epilepsy Foundation of America in 1993. Of all the onsets of SE, 43.1% were RSE, viral encephalitis more often the primary cause ofRSE （P=0.001）; on the contrary, NRSE was more often occurred to patients with history of epilepsy （P=0.000） and in SE induced by the change in medication （P=0.003）; GCS score and prognosis in RSE group were significantly poor （P=0.000, respectively）. Conclusion SE is frequently refractory to first- and second- line antiepileptic drugs. Viral encephalitis is a predictor of great importance for RSE, with markedly poor outcome. Up until now, we still cannot give a reasonable prescription for the treatment of RSE.

关 键 词：顽固性癫痫持续状态 癫痫持续状态 危险因素 

分 类 号：R742.1[医药卫生—神经病学与精神病学]