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[急性症状性癫痫]

[Acute symptomatic epilepsies].

作者信息

Mauri-Llerda J A, Tejero-Juste C, Escalza-Cortina I, Jericó I, Morales-Asín F

机构信息

Servicio de Neurología, Hospital Clínico Lozano Blesa, Zaragoza, España.

出版信息

Rev Neurol. 2000;31(8):770-4.

Abstract

OBJECTIVES

To review the differentiating characteristics of symptomatic acute epilepsies, epidemiology, aetiology and controversies over treatment, and describe our experience with symptomatic acute epilepsy in cerebrovascular disorders.

DEVELOPMENT AND CONCLUSIONS

The so-called symptomatic acute epilepsies show clearly differentiated characteristics with regard to true epileptic disorders: 1. A clearly identified causal association; 2. Generally tend not to recur; 3. Usually long-term anti-epileptic treatment is not necessary. Therefore the most suitable term for them is symptomatic acute seizures. They make up a large proportion of all newly-diagnosed epilepsies around 40%. The highest incidence occurs during the first year of life (probably because of the high incidence of seizures due to encephalopathies, metabolic disorders and infections) and in elderly patients (especially in relations to cerebrovascular disorders). The commonest causes are: cerebrovascular disorders, head injury, infections of the central nervous system, alcohol and drugs. The risk of subsequent epilepsy is increased in a subgroup of these patients, especially in cases with associated cerebrovascular disorders, head injuries and central nervous system infection. Long-term preventive treatment is rarely indicated in these patients.

摘要

目的

回顾症状性急性癫痫的鉴别特征、流行病学、病因及治疗争议,并描述我们在脑血管疾病所致症状性急性癫痫方面的经验。

发展与结论

所谓的症状性急性癫痫与真正的癫痫疾病相比具有明显不同的特征:1. 有明确的因果关联;2. 一般不易复发;3. 通常无需长期抗癫痫治疗。因此,最适合它们的术语是症状性急性发作。它们在所有新诊断的癫痫中占很大比例,约为40%。发病率最高的年龄段是在生命的第一年(可能是由于脑病、代谢紊乱和感染导致的发作发生率较高)以及老年患者(特别是与脑血管疾病相关的患者)。最常见的病因是:脑血管疾病、头部损伤、中枢神经系统感染、酒精和药物。这些患者中的一个亚组后续发生癫痫的风险增加,特别是伴有脑血管疾病、头部损伤和中枢神经系统感染的病例。这些患者很少需要长期预防性治疗。

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