阿尔茨海默病共患癫痫的回顾性临床研究  

Epilepsy in Alzheimer's disease:a retrospective study

作　　者：黎洵 刘帅[1] 杨云[1] 张莹[1] 纪勇[1] 岳伟[1] Li Xun;Liu Shuai;Yang Yun;Zhang Ying;Ji Yong;Yue Wei(Department of Neurology,Tianjin Huanhu Hospital,Tianjin 300350,China)

机构地区：[1]天津市环湖医院神经内科,天津300350

出　　处：《中华老年医学杂志》2021年第2期163-167,共5页Chinese Journal of Geriatrics

基　　金：天津市自然科学基金重点项目(19JCZDJC36500)。

摘　　要：目的分析阿尔茨海默病(AD)患者的癫痫患病率及相关临床特征。方法回顾性研究自2010年1月至2019年1月天津市环湖医院痴呆与变性病专病数据库中AD患者,统计AD合并癫痫的患病率,分析神经心理学评估特点、临床发作表现、脑电图特征等,并与不合并癫痫的AD患者进行对比。结果在376例AD患者中11.4%合并癫痫。其中4.0%患者出现非诱发性癫痫发作早于AD确诊时间,7.5%在AD确诊后出现。AD患者中首次出现癫痫年龄为(59.8±19.9)岁,确诊为AD年龄为(62.8±6.6)岁。癫痫类型多为局灶性发作(65.1%),脑电图表现多为局灶慢波(69.8%)及局灶癫痫样放电(23.3%)。合并癫痫AD患者较不合并癫痫AD患者确诊AD时间提前8年。结论癫痫在AD患者中具有更高的患病率,癫痫可能是认知损害进展为AD的危险因素,早期识别癫痫及认知损害可能对延缓痴呆进展有积极意义。Objective To analyze the prevalence of epilepsy and its clinical features in patients with Alzheimer's disease(AD).Methods Clinical data of patients with AD from a separate database of Tianjin Huanhu Hospital for dementia and degenerative diseases from January 2010 to January 2019 were retrospectively examined.The prevalence of AD combined with epilepsy was analyzed.The characteristics from neuropsychological assessment,clinical manifestations of epileptic attacks,electroencephalogic patterns and other features were analyzed and compared with those of AD patients without epilepsy.Results Of 376 AD patients,11.4%had epilepsy,with 4.0%showing non-induced seizures before AD diagnosis and 7.5%after AD diagnosis.The average age of AD patients at first onset of epilepsy was 59.8±19.9 years,and the average age of patients at initial diagnosis with AD was 62.8±6.6 years.The most common type was focal seizures(65.1%),and EEG showed mostly focal slow waves(69.8%)and focal epileptiform discharges(23.3%).The AD diagnosis for patients with epilepsy was 8 years earlier than those without epilepsy.Conclusions Epilepsy has a high prevalence in AD patients,and seizures may be a risk factor for progression from cognitive impairment to AD.Early identification of seizures and cognitive impairment may have a positive effect on delaying the progression of dementia.

关 键 词：癫痫 阿尔茨海默病 患病率 

分 类 号：R742.1[医药卫生—神经病学与精神病学] R749.16[医药卫生—临床医学]