特发性癫痫相关性系统性红斑狼疮的临床分析  

Clinical study of idiopathic epilepsy with systemic lupus erythematosus

作　　者：赵爱云 顾纪平 彭智芳 罗云[1] ZHAO Aiyun;GU Jiping;PENG Zhifang;LUO Yun(Departmentof Neurology,Sijing Hospital of Songjiang,Shanghai 201601,China)

机构地区：[1]上海市松江区泗泾医院神经内科,上海201601

出　　处：《中国实用神经疾病杂志》2018年第7期774-778,共5页Chinese Journal of Practical Nervous Diseases

基　　金：上海市松江区泗泾医院基金(编号:2016123)

摘　　要：目的研究特发性癫痫合并系统性红斑狼疮(systemic lupus erythematosus,SLE)的发生率、临床特征与治疗。方法回顾分析2005-01—2017-05就诊的109例特发性癫痫患者,分析合并SLE的发生率,将8例癫痫合并SLE的患者为观察组,101例不伴SLE病人为对照组,分析观察组的临床特征,比较2组患者的差异。结果 109例特发性癫痫患者中有8例并发系统性红斑狼疮,发生率7.3%。女7例,男1例。平均发病年龄与不伴SLE患者的发病年龄无明显差异[(15±5)岁比(18±3)岁,P>0.05)]。2例在诊断癫痫同时被诊断为SLE,4例诊断癫痫之后诊断SLE,2例诊断SLE后诊断癫痫。癫痫伴发SLE患者多伴记忆障碍,精神症状等。脑MRI颞叶长T1、长T2信号,脑部正电子发射扫描(PET)表现为颞叶放射性浓集;脑脊液炎性改变;血及脑脊液检测发现抗DNA抗体、抗磷脂抗体等。癫痫合并SLE患者,抗癫痫药合用激素有效。结论特发性癫痫患者,尤其女性,脑脊液呈炎性改变,血及脑脊液检查发现抗体,脑MRI颞叶长T1、长T2信号,合并精神症状、记忆力障碍等可确诊SLE。抗癫痫药与激素合用效果好。Objective To investigate the incidence,clinical feature and treatment of idiopathic epilepsy(EPi)with systemic lupus erythematosus(SLE).Methods We studied 109 patients with EPi from 2005 2017,analyzed the incidence rate of SLE,and 8 EPi patients complicated with SLE were assinged to the observation group,101 cases without SLE to the control group.Clinical features were compared between the groups.Results Out of 109 patients with Epi in our database,SLE were found in 8 cases(7 female and 1 male).The incidence was 7.3%.The mean age of EPi patients with SLE at the time of the diagnosis was as old as that of the patients without SLE(15±5 vs.18±3,P>0.05).2 patients were found to have SLE while diagnosed with EPi,4 cases were found to have SLE after the diagnose of EPi,and 2 cases were found to have EPi after the diagnose of SLE.EPi patients with SLE have memory impairment,mental symptom et al.MRI showed abnormal high signal intensity in temporal lobe on T 2 weighted imagings.Highly significant focal hypermetabolism in temporal lobe was found by FDG_PET;Cerebrospinal fluid(CSF)was inflammatorily changed;anti DNA antibody,anti phospholipid antibody were found in blood and cerebrospinal fluid.The treatment(antiepileptic with hormone)had positive effect.Conclusion Epi patients,especially female patients,can be diagnosed with SLE if the CSF is inflammatorily changed,have positive antibody in blood and cerebrospinal fluid,or have brain MRI results with temporal lobe long T 1,long T 2 signals,have memory impairment or mental symptom.

关 键 词：癫痫 系统性红斑狼疮 脑脊液 神经系统损伤 激素 

分 类 号：R742.1[医药卫生—神经病学与精神病学]