甘孜藏族自治州首次痫性发作住院患者临床特征回顾性分析
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摘要
目的研究旨在为甘孜藏族自治州癫痫发作提供临床特征的数据,以改善该地区的癫痫发作防治策略。方法研究回顾性分析了甘孜藏族自治州人民医院神经内科2015年1月–2017年10月期间收治的因首次发作入院的癫痫患者的临床记录,总结其临床特点。结果研究共纳入101例患者,平均年龄(43.0±18.4)岁。29例因癫痫持续状态入院,其中5例(17.2%)在入院后的30 d内死亡。45例为急性症状性癫痫发作,颅内感染是最常见的诱因(n=22,48.9%),其中包括脑囊虫(n=4,8.9%)、结核感染(n=8,17.7%),病毒感染(n=7,15.6%)和其他(n=3,6.7%)。其他诱因包括脑血管疾病(n=13,28.8%),高原反应(n=3,6.7%),酒精相关或急性戒断综合症(n=3,6.7%)和其他原因(n=3,6.7%)。结论在甘孜藏族自治州,控制颅内感染对预防和控制急性癫痫的急性症状性发作较为重要。对当地基层医生进行癫痫持续状态诊治的培训将有助于更好地管理该地区癫痫发作。
Objective This study aimed to provide data about the clinical features of first seizure in the Ganzi Tibetan Autonomous Prefecture to improve the strategies for epilepsy prevention and control in this region.Methods We reviewed the clinical record of patients with first seizure in Neurology Department,Ganzi Tibetan Autonomous Prefecture People’s Hospital between January 2015 and October 2017 and summarised their clinical features.Results One hundred and one patients were included in this study with the average age of(43.0±18.4)years.Twenty-nine cases were diagnosed as statusepilepticus,5(17.2%)of whom died in 30 days.Among the 45 patients diagnosed with acute symptomatic seizure,22 cases(48.9%)were caused by cerebral infection,including neurocysticercosis(n=4,8.9%),tuberculous infection(n=8,17.7%)and viral infection(n=7,15.6%).Other causes of acute symptomatic seizure included cerebrovascular diseases(n=13,28.8%),high altitude(n=3,6.7%)and alcohol related or alcohol withdrawl(n=3,6.7%).Conclutions These data suggest that the control of cerebral infections is essential for the prevention and treatment of seizures in the Ganzi Tibetan Autonomous Prefecture.Education of local primary doctors about status epilepticus will enable better management of seizures in this population.
Objective This study aimed to provide data about the clinical features of first seizure in the Ganzi Tibetan Autonomous Prefecture to improve the strategies for epilepsy prevention and control in this region.Methods We reviewed the clinical record of patients with first seizure in Neurology Department,Ganzi Tibetan Autonomous Prefecture People’s Hospital between January 2015 and October 2017 and summarised their clinical features.Results One hundred and one patients were included in this study with the average age of(43.0±18.4)years.Twenty-nine cases were diagnosed as statusepilepticus,5(17.2%)of whom died in 30 days.Among the 45 patients diagnosed with acute symptomatic seizure,22 cases(48.9%)were caused by cerebral infection,including neurocysticercosis(n=4,8.9%),tuberculous infection(n=8,17.7%)and viral infection(n=7,15.6%).Other causes of acute symptomatic seizure included cerebrovascular diseases(n=13,28.8%),high altitude(n=3,6.7%)and alcohol related or alcohol withdrawl(n=3,6.7%).Conclutions These data suggest that the control of cerebral infections is essential for the prevention and treatment of seizures in the Ganzi Tibetan Autonomous Prefecture.Education of local primary doctors about status epilepticus will enable better management of seizures in this population.
引文
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3 Goverment GTAP.Brief introduction of Ganzi.GzzGovCn/10000110011/10012/10015/2015/07/29/10481707Shtml n.d.http://gzz.gov.cn/10000110001/10002/10437244.shtml(accessed December 6,2017).
4 Fisher RS,Acevedo C,Arzimanoglou A,et al.ILAE Official Report:A practical clinical definition of epilepsy.Epilepsia,2014,55(4):475-482.
5 Fisher RS,Boas WVE,Blume W,et al.Epileptic seizures and epilepsy:definitions proposed by the International League Against Epilepsy(ILAE)and the International Bureau for Epilepsy(IBE).Epilepsia,2005,46(4):470-472.
6 Beghi E,Carpio A,Forsgren L,et al.Recommendation for a definition of acute symptomatic seizure.Epilepsia,2010,51(4):671-675.
7 Hauser WA,Annegers JF,Rocca WA.Descriptive epidemiology of epilepsy:contributions of population-based studies from rochester,minnesota.Mayo ClinProc,1996,71(6):576-586.
8 Trinka E,Cock H,Hesdorffer D,et al.A definition and classification of status epilepticus-Report of the ILAE Task Force on Classification of Status Epilepticus.Epilepsia,2015,56(10):1515-1523.
9 Commission on Classification and Terminology of the International League Against Epilepsy.Proposal for revised clinical and electroencephalographic classification of epileptic seizures.From the Commission on Classification and Terminology of the International League Against Epilepsy.Epilepsia,1981,22(4):489-501.
10 Commission on Classification and Terminology of the International League Against Epilepsy.Proposal for revised classification of epilepsies and epileptic syndromes.Commission on Classification and Terminology of the International League Against Epilepsy.Epilepsia,1989,30(4):389-399.
11 Hauser WA,Annegers JF,Kurland LT.Prevalence of Epilepsy in Rochester,Minnesota:1940-1980.Epilepsia,1991,32(4):429-445.
12 Gao L,Xia L,Pan SQ,et al.Burden of epilepsy:A prevalence-based cost of illness study of direct,indirect and intangible costs for epilepsy.Epilepsy Res,2015,110:146-156.
13 Annegers JF,Hauser WA,Lee JRJ,et al.Incidence of acute symptomatic seizures in rochester,minnesota,1935-1984.Epilepsia,1995,36(4):327-333.
14 Wang WZ,Wu JZ,Ma GY,et al.Efficacy assessment of phenobarbital in epilepsy:a large community-based intervention trial in rural China.Lancet Neurol,2006,5(1):46-52.
15 Ding D,Hong Z,Wang WZ,et al.Assessing the disease burden due to epilepsy by disability adjusted life year in rural China.Epilepsia,2006,47(12):2032-2037.
16 Logroscino G,Hesdorffer DC,Cascino G,et al.Short-term mortality after a first episode of status epilepticus.Epilepsia,1997,38(12):1344-1349.
17 Logroscino G,Hesdorffer DC,Cascino G,et al.Mortality after a first episode of status epilepticus in the United States and Europe.Epilepsia,2005,46(Suppl 11):46-48.
18 Nwani PO,Nwosu MC,Nwosu MN.Epidemiology of acute symptomatic seizures among adult medical admissions.Epilepsy Res Treat,2016,2016:1-5.
19 Li T,Craig PS,Ito A,et al.Taeniasis/cysticercosis in a Tibetan population in Sichuan Province,China.Acta Trop,2006,100(3):223-231.
20 Li TY,Qiu JM,Yang W,et al.Echinococcosis in Tibetan populations,western Sichuan Province,China.Emerg Infect Dis,2005,11(12):1866-1873.
21 Baumgartner RW,Siegel AM,Hackett PH,Going high with preexisting neurological conditions.High Alt Med Biol,2007,8(2):108-116.
22 Daleau P,Morgado DC,Iriarte CA,et al.New epilepsy seizure at high altitude without signs of acute mountain sickness or high altitude cerebral edema.High Alt Med Biol,2006,7(1):81-83.
2 Zhao YH,Zhang Q,Long N,et al.Prevalence of epilepsy and alcohol-related risk in Zayul County,Tibet Autonomous Region in China:An initial survey.Epilepsy Behav,2010,19(4):635-638.
3 Goverment GTAP.Brief introduction of Ganzi.GzzGovCn/10000110011/10012/10015/2015/07/29/10481707Shtml n.d.http://gzz.gov.cn/10000110001/10002/10437244.shtml(accessed December 6,2017).
4 Fisher RS,Acevedo C,Arzimanoglou A,et al.ILAE Official Report:A practical clinical definition of epilepsy.Epilepsia,2014,55(4):475-482.
5 Fisher RS,Boas WVE,Blume W,et al.Epileptic seizures and epilepsy:definitions proposed by the International League Against Epilepsy(ILAE)and the International Bureau for Epilepsy(IBE).Epilepsia,2005,46(4):470-472.
6 Beghi E,Carpio A,Forsgren L,et al.Recommendation for a definition of acute symptomatic seizure.Epilepsia,2010,51(4):671-675.
7 Hauser WA,Annegers JF,Rocca WA.Descriptive epidemiology of epilepsy:contributions of population-based studies from rochester,minnesota.Mayo ClinProc,1996,71(6):576-586.
8 Trinka E,Cock H,Hesdorffer D,et al.A definition and classification of status epilepticus-Report of the ILAE Task Force on Classification of Status Epilepticus.Epilepsia,2015,56(10):1515-1523.
9 Commission on Classification and Terminology of the International League Against Epilepsy.Proposal for revised clinical and electroencephalographic classification of epileptic seizures.From the Commission on Classification and Terminology of the International League Against Epilepsy.Epilepsia,1981,22(4):489-501.
10 Commission on Classification and Terminology of the International League Against Epilepsy.Proposal for revised classification of epilepsies and epileptic syndromes.Commission on Classification and Terminology of the International League Against Epilepsy.Epilepsia,1989,30(4):389-399.
11 Hauser WA,Annegers JF,Kurland LT.Prevalence of Epilepsy in Rochester,Minnesota:1940-1980.Epilepsia,1991,32(4):429-445.
12 Gao L,Xia L,Pan SQ,et al.Burden of epilepsy:A prevalence-based cost of illness study of direct,indirect and intangible costs for epilepsy.Epilepsy Res,2015,110:146-156.
13 Annegers JF,Hauser WA,Lee JRJ,et al.Incidence of acute symptomatic seizures in rochester,minnesota,1935-1984.Epilepsia,1995,36(4):327-333.
14 Wang WZ,Wu JZ,Ma GY,et al.Efficacy assessment of phenobarbital in epilepsy:a large community-based intervention trial in rural China.Lancet Neurol,2006,5(1):46-52.
15 Ding D,Hong Z,Wang WZ,et al.Assessing the disease burden due to epilepsy by disability adjusted life year in rural China.Epilepsia,2006,47(12):2032-2037.
16 Logroscino G,Hesdorffer DC,Cascino G,et al.Short-term mortality after a first episode of status epilepticus.Epilepsia,1997,38(12):1344-1349.
17 Logroscino G,Hesdorffer DC,Cascino G,et al.Mortality after a first episode of status epilepticus in the United States and Europe.Epilepsia,2005,46(Suppl 11):46-48.
18 Nwani PO,Nwosu MC,Nwosu MN.Epidemiology of acute symptomatic seizures among adult medical admissions.Epilepsy Res Treat,2016,2016:1-5.
19 Li T,Craig PS,Ito A,et al.Taeniasis/cysticercosis in a Tibetan population in Sichuan Province,China.Acta Trop,2006,100(3):223-231.
20 Li TY,Qiu JM,Yang W,et al.Echinococcosis in Tibetan populations,western Sichuan Province,China.Emerg Infect Dis,2005,11(12):1866-1873.
21 Baumgartner RW,Siegel AM,Hackett PH,Going high with preexisting neurological conditions.High Alt Med Biol,2007,8(2):108-116.
22 Daleau P,Morgado DC,Iriarte CA,et al.New epilepsy seizure at high altitude without signs of acute mountain sickness or high altitude cerebral edema.High Alt Med Biol,2006,7(1):81-83.