老年癫痫患者的临床特征分析  

Clinical characteristics of epilepsy in the elderly

作　　者：邵晨婧 李德生[1] 王子玉 郎森阳[1] 于生元[1] 王湘庆[1] Shao Chenjing;Li Desheng;Wang Ziyu;Lang Senyang;Yu Shengyuan;Wang Xiangqing(Department of Neurology,Chinese PLA General Hospital,Beijing 100853,China)

机构地区：[1]解放军总医院神经内科,北京100853

出　　处：《中华老年心脑血管病杂志》2018年第8期788-791,共4页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

摘　　要：目的探讨老年癫痫患者的病因、临床特征及治疗现状。方法采用回顾性研究的方法,收集2015年9月~2017年12月在我院就诊的癫痫患者363例,根据发病时间分为迟发组134例,早发组56例与中青年组173例。对比分析3组病因、发作类型、脑电图表现、并发症及抗癫痫药物治疗情况。结果 3组男性、年龄、起病年龄、病程、脑血管病、癫痫复杂部分发作、单纯部分发作及强直阵挛+复杂部分发作比例比较,差异有统计学意义(P<0.05,P<0.01)。与中青年组比较,迟发组脑血管病及复杂部分发作类型比例均明显升高(P<0.05,P<0.01)。迟发组最常见病因为脑血管病(18.7%)。3组最常见的发作类型均为强直阵挛发作。早发组强直阵挛+复杂部分发作率明显高于中青年组和迟发组(33.9%vs 26.0%和9.0%,P<0.01),中青年组强直阵挛+复杂部分发作率亦明显高于迟发组,差异有统计学意义(26.0%vs 9.0%,P<0.05)。3组并发症发生率及单一药物治疗比例比较差异有统计学意义(P<0.01)。老年癫痫患者最常见并发症为高血压、糖尿病等。3组脑电图阳性率比较无显著差异(P>0.05)。结论脑血管病是迟发老年癫痫最常见的病因,最常见的发作类型是强直阵挛发作。老年癫痫患者伴发疾病以高血压为主,治疗以单一药物为主。Objective To study the cause,clinical characteristics and current treatment of epilepsy in the elderly.Methods Three hundred and sixty-three epilepsy patients were divided into lateonset group（n=134）,early-onset group（n=56）,young and middle-aged group（n=173）.The cause of epilepsy,types of epilepsy seizure,EEG,complications and antiepileptic treatment were compared and analyzed.Results A significant difference was found in male gender,age,onset age of epilepsy,course of epilepsy,incidence of cerebrovascular disease,complex and simple partial seizure of epilepsy,tonic clonus＋complex partial seizure among the 3 groups（P〈0.05,P〈0.01）.The incidence of cerebrovascular disease and complex partial seizure of epilepsy was higher in late-onset group than in young and middle-aged group（P〈0.05,P〈0.01）.Cerebrovascular disease was the most common cause of epilepsy in late-onset group,accounting for 18.7%.Tonic clonic seizure was the most common type of epilepsy seizure in 3 groups.The incidence of tonic clonus＋complex partial seizure was significantly higher in early-onset group than in young and middle-aged group（P〈0.01）and in young and middle-aged group than in late-onset group（P〈0.05）.The significant differences were found in the incidence of complications and the ratio of single drug treatment among the 3 groups（P〈0.01）.Hypertension was the most common complication in elderly epilepsy patients.Conclusion Cerebrovascular disease is the most common cause of late-onset epilepsy in the elderly with tonic-clonic seizure as the most common type.The incidence of hypertension is higher in elderly epilepsy patients.These are usually treated with single antiepileptic drug.

关 键 词：癫痫 癫痫 强直阵挛性 高血压 脑电描记术 抗惊厥药 

分 类 号：R742.1[医药卫生—神经病学与精神病学]