Garzon Eliana, Fernandes Regina Maria França, Sakamoto Américo Ceiki
Department of Neurology and Neurosurgery, Federal University of São Paulo, São Paulo, Brazil.
Seizure. 2003 Sep;12(6):337-45. doi: 10.1016/s1059-1311(02)00324-2.
To analyse clinical data including aetiology, age, antecedents, classification and mortality in human status epilepticus (SE), and to assess prognostic factors for mortality.
A prospective study was performed, including detailed analysis of clinical and laboratorial data of SE in individuals of any age, except neonates.
One hundred and eleven SE were included, with patients' age ranging from 3 months to 98 years. SE incidence peaked in the first year of life, and 59.4% of the individuals had previous epilepsy while 40.6% had not. The main underlying causes were noncompliance to treatment in the first group, and CNS infection, stroke and metabolic disturbances in the second group. Overall mortality was 19.8%, and deaths were correlated to aetiology and patient's age. Refractory SE affected 11.7% of the cases. Clinical types included focal, secondarily generalised and generalised SE. Clinical and clinicoelectrographic classifications were convergent, but EEG was essential for the diagnosis in 4.5% of the cases.
Epileptic patients are at greater risk to develop SE, however, individuals with no prior history of epilepsy and acute neurological problems can also present SE. Aetiology varies with patient's age, and mortality is high and related to age and underlying causes. Clinical and clinicoelectrographic classifications are usually convergent, but in some cases the diagnosis of SE would not be established without the EEG.
分析人类癫痫持续状态(SE)的临床数据,包括病因、年龄、既往史、分类及死亡率,并评估死亡的预后因素。
进行了一项前瞻性研究,包括对除新生儿外任何年龄个体的SE临床和实验室数据进行详细分析。
纳入111例SE患者,年龄范围为3个月至98岁。SE发病率在生命的第一年达到峰值,59.4%的个体既往有癫痫病史,40.6%无癫痫病史。第一组的主要潜在病因是治疗依从性差,第二组是中枢神经系统感染、中风和代谢紊乱。总体死亡率为19.8%,死亡与病因和患者年龄相关。难治性SE影响11.7%的病例。临床类型包括局灶性、继发性全身性和全身性SE。临床和临床脑电图分类一致,但脑电图在4.5%的病例中对诊断至关重要。
癫痫患者发生SE的风险更高,然而,既往无癫痫病史和急性神经系统问题的个体也可能出现SE。病因因患者年龄而异,死亡率高且与年龄和潜在病因有关。临床和临床脑电图分类通常一致,但在某些情况下,若无脑电图则无法确立SE的诊断。