Sillanpää Matti, Shinnar Shlomo
Department of Pediatric Neurology, University of Turku, Turku Finland.
Ann Neurol. 2002 Sep;52(3):303-10. doi: 10.1002/ana.10286.
Little is known about the time course over which status epilepticus occurs in childhood-onset epilepsy and its impact on long-term prognosis. A population-based cohort of 150 children younger than age 16 years with new onset epilepsy between 1961 and 1964 residing in the catchment area of Turku University Hospital was observed prospectively until 1997. The occurrence of status epilepticus and recurrent status epilepticus, risk factors for status epilepticus, and the impact of status epilepticus on prognosis were examined. Of the 150 cases, 41 patients (27%) experienced an episode of status epilepticus of whom 22 patients (56%) had two or more episodes. The risk of status epilepticus was highest at the onset of the disorder with 30 (73%) cases occurring before (n = 12) or at (n = 18) onset and 37 (90%) cases within 2 years of onset. On multivariable analysis, risk factors for status epilepticus included remote symptomatic cause, age of onset 6 years or younger, and partial seizures. Specific epilepsy syndromes also were associated with a differential risk of status epilepticus. The occurrence of status epilepticus did not alter the mortality rates and had only a modest impact on the probability of attaining remission. In subjects with no other neurological handicap, social and educational outcomes were similar in those with status epilepticus and those with no history of status epilepticus. We conclude that status epilepticus is a common occurrence in childhood-onset epilepsy. When it does occur, it occurs early in the course of the disorder. The occurrence of status epilepticus does not appear to have significant adverse impact on long-term prognosis of childhood-onset epilepsy.
关于儿童期癫痫发作时癫痫持续状态的病程及其对长期预后的影响，目前所知甚少。对1961年至1964年间居住在图尔库大学医院服务区域内的150名16岁以下新发癫痫儿童进行了基于人群的队列前瞻性观察，直至1997年。研究了癫痫持续状态和反复癫痫持续状态的发生情况、癫痫持续状态的危险因素以及癫痫持续状态对预后的影响。在这150例病例中，41例患者（27%）经历了癫痫持续状态发作，其中22例患者（56%）有两次或更多次发作。癫痫持续状态的风险在疾病发作时最高，30例（73%）在发作前（n = 12）或发作时（n = 18）发生，37例（90%）在发作后2年内发生。多变量分析显示，癫痫持续状态的危险因素包括既往有症状性病因、发病年龄6岁或更小以及部分性发作。特定的癫痫综合征也与癫痫持续状态的不同风险相关。癫痫持续状态的发生并未改变死亡率，对缓解概率的影响也较小。在没有其他神经功能障碍的受试者中，有癫痫持续状态史和无癫痫持续状态史的受试者在社会和教育方面的结局相似。我们得出结论，癫痫持续状态在儿童期癫痫中很常见。当它确实发生时，通常在疾病过程的早期出现。癫痫持续状态的发生似乎对儿童期癫痫的长期预后没有显著的不利影响。
