老年癫痫首次发作病因和临床特征分析  

Analysis of the etiology and clinical features of first epilepsy in the elderly

作　　者：冯芹[1] 何妮[1] 张萍[1] 范真[1] 张标[1] 易兴阳[1] 王淳[1] 

机构地区：[1]四川省德阳市人民医院神经内科,618000

出　　处：《中国现代医药杂志》2017年第10期36-38,共3页Modern Medicine Journal of China

摘　　要：目的分析老年癫痫患者首次癫痫发作的病因、临床发作类型、共病情况及预后。方法对127例老年癫痫患者临床资料进行回顾性分析。结果老年癫痫患者常见病因为脑血管病71例(55.9%),脑外伤11例(8.7%),脑肿瘤9例(7.1%),其他16例(12.6%),未明病因20例(15.7%)。发作类型以全面强直-阵挛发作最常见,共76例(59.8%),其次为局灶性发作37例(29.1%)。常见的共病分别为高血压病54例(42.5%),糖尿病28例(22.0%),高脂血症21例(16.5%)。脑电图特点:97例(76.4%)未见明显异常,19例(15.0%)可见局灶性棘波、尖波、阵发性局灶性慢波,11例(8.7%)可见低波幅慢波。单药治疗81例(63.8%),联合用药21例(16.5%),中药治疗7例(5.5%),未接受药物治疗者18例(14.2%)。127例患者平均随访时间为46个月,其中死亡38例(29.9%),失访12例(9.4%)。结论脑血管病为老年癫痫的主要原因,且以全面性发作形式为主。老年癫痫患者共病较多,死亡率高,治疗应谨慎选药,并需密切关注药物相互之间的作用。目前治疗主要以抗癫痫药物单药治疗为主。Objective To investigate the etiologies,clinical features,co-morbidity and prognosis of senile epilepsy.Methods The clinical characteristics of 127 elderly patients with epilepsy were retrospectively studied.Results The common causes of senile epilepsy were cerebrovascular disease（71 cases,55.9%）,brain trauma（11 cases,8.7%）,brain tumor（9 cases,7.1%）,others（16 cases,12.6%）,unknown etiology（20 cases,15.7%）.The most common type was generalized tonic-clonic seizures（76 cases,59.8%）,followed by focal seizures（37 cases,29.1%）.The most comorbidity of senile epilepsy was hypertension（54 cases,42.5%）,diabetes（28 cases,22.0%）,hyperlipidemia（21 cases,16.5%）.Electroencephalogram（EEG） mostly showed normal（97 cases,76.4%）,19 cases presented with focal spike wave,focal spark wave,paroxysmal focal slow wave,11 cases showed low amplitude slow wave.The proportion of single drug treatment was 81 cases（63.8%）,combined drug treatment 21 cases（16.5%）,traditional Chinese medicine treatment 7 cases（5.5%）,18 cases（14.2%）without drug treatment.Conclusion Cerebrovascular disease is the main cause of senile epilepsy,senile epilepsy is more likely to have generalized seizures.Most senile epilepsy has comorbidity,high mortality rate.Careful selection of drug and close attention to the interaction between drugs are needed.Most of the senile epilepsy patients are treated with single antiepileptic drug.

关 键 词：老年癫痫 发病原因 临床特征 

分 类 号：R742.1[医药卫生—神经病学与精神病学]