老年期痴呆新发癫痫的临床分析  

Clinical analysis of new-onset epilepsy in elderly dementia

作　　者：王艳淑 李嘉辰 夏晴 潘雁斐 刘献增 Wang Yanshu;Li Jiachen;Xia Qing;Pan Yanfei;Liu Xianzeng(Department of Neurology,Peking University International Hospital,Beijing 102206,China)

机构地区：[1]北京大学国际医院神经内科,102206

出　　处：《中华老年心脑血管病杂志》2024年第8期939-941,共3页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

摘　　要：目的探究老年期痴呆新发癫痫的病因、癫痫类型、治疗及预后。方法回顾性分析2017年1月至2023年12月北京大学国际医院神经内科收治的老年期痴呆新发癫痫患者45例,根据病因分为变性病痴呆组[以阿尔茨海默病(Alzheimer's disease,AD)为主,AD痴呆组]24例和非变性病痴呆组(非AD痴呆组)21例。比较2组癫痫分类、脑电图表现;应用抗癫痫药物治疗3个月后,比较2组用药情况及疗效。结果每例患者至少有1种癫痫发作类型,AD痴呆组全面性发作低于非AD痴呆组,部分性发作、非惊厥性癫痫发作高于非AD痴呆组(P<0.05,P<0.01);每例患者至少有1种脑电图异常,2组脑电图表现比较,差异无统计学意义(P>0.05)。45例患者中42例(93.3%)接受了抗癫痫药物,38例(90.5%)癫痫发作得到较好控制,其中AD痴呆组单联抗癫痫药物有效率优于非AD痴呆组(95.5%vs 85.7%,P<0.05)。结论痴呆合并癫痫(尤其是非惊厥性癫痫发作)常难以发现,对老年期痴呆患者进行持续脑电图监测十分必要。老年期痴呆新发癫痫大多可以通过抗癫痫药物治疗得到较好的控制。Objective To explore the etiology,types,treatment,and prognosis of new-onset epilepsy in elderly dementia.Methods A retrospective analysis was conducted on 45 new-onset epilepsy in elderly dementia admitted to our department from January 2017 to December 2023.According to their etiology,they were divided into a degenerative dementia group(with AD as the main cause,AD dementia group,24 cases,)and a non-degenerative dementia group(non-AD dementia group,21 cases).Seizure types and and electroencephalogram(EEG)findings were compared between the two groups.The medication and efficacy were also compared between the two groups in 3 months after treatment with antiepileptic drugs.Results Each patient had at least one type of seizure.The AD dementia group had a lower incidence of generalized seizure,but higher incidences of focal seizure and non-convulsive seizure(NCS)when compared with the non-AD dementia group(P<0.05,P<0.01).At least one type of abnormal EEG findings was observed in each patient,but there was no statistical difference in the occurrence of EEG abnormalities between the two groups(P>0.05).Among the 45 patients,42(93.3%)received antiepileptic drugs,and 38(90.5%)patients were well controlled,with the AD dementia group having a higher effective rate of single antiepileptic drug than the non-AD dementia group(95.5%vs 85.7%,P<0.05).Conclusion Dementia combined with epilepsy(especially NCS)is often hard to detect,and continuous EEG monitoring is essential for elderly dementia patients.Most new-onset epilepsy in elderly dementia can be effectively controlled through antiepileptic drug therapy.

关 键 词：阿尔茨海默病 癫痫 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]