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癫痫发作使婴幼儿和儿童细菌性脑膜炎病情复杂化。

Seizures complicating infantile and childhood bacterial meningitis.

作者信息

Chang Chin-Jung, Chang Hsueh-Wen, Chang Wen-Neng, Huang Li-Tung, Huang Song-Chei, Chang Ying-Chao, Hung Pi-Lien, Chang Chen-Sheng, Chuang Yao-Chung, Huang Chi-Ren, Tsai Nai-Wen, Tsui Huan-Wen, Wang Kuo-Wei, Lu Cheng-Hsien

机构信息

Department of Pediatrics, Buddhist Dalin Tzu Chi General Hospital, Chia-Yi, Kaohsiung, Taiwan.

出版信息

Pediatr Neurol. 2004 Sep;31(3):165-71. doi: 10.1016/j.pediatrneurol.2004.03.009.

Abstract

In this study, 116 patients, at least 1 month of age but younger than 5 years, were identified with culture-proven bacterial meningitis. A comparison was made between the clinical data of the patients with and without seizures during hospitalization. Seizures during acute bacterial meningitis accounted for 47% (55/116) of the episodes. Time interval between the onset of bacterial meningitis and that of seizures was 1 to 20 days (mean, 4 days). Twelve of these 55 patients had one or more afebrile seizures after completing the treatment. At follow-up of at least 1 year after completing treatment, 26 patients had good outcomes, whereas the other 29 patients had poor outcomes. A strong correlation between the findings of abnormalities through neuroimaging and the occurrence of seizures during hospitalization was observed. The long-term outcomes of patients with infantile and childhood bacterial meningitis, who had seizures during the acute phase of bacterial meningitis, were worse than the outcomes of those who did not have such seizures. No child developed late seizures unless there were acute seizures. Factors associated with seizures during acute bacterial meningitis include disturbed consciousness on admission, abnormal neuroimaging findings, and low glucose and high concentration of total proteins in cerebrospinal fluid.

摘要

在本研究中,确定了116例年龄至少1个月但小于5岁、经培养证实患有细菌性脑膜炎的患者。对住院期间有癫痫发作和无癫痫发作患者的临床资料进行了比较。急性细菌性脑膜炎期间的癫痫发作占病例的47%(55/116)。细菌性脑膜炎发病与癫痫发作的时间间隔为1至20天(平均4天)。这55例患者中有12例在完成治疗后出现一次或多次无热惊厥。在完成治疗后至少随访1年时,26例患者预后良好,而其他29例患者预后不良。观察到神经影像学异常结果与住院期间癫痫发作的发生之间存在密切相关性。在细菌性脑膜炎急性期有癫痫发作的婴幼儿和儿童细菌性脑膜炎患者的长期预后比无此类癫痫发作的患者差。除非有急性癫痫发作,否则没有儿童会发生迟发性癫痫。急性细菌性脑膜炎期间与癫痫发作相关的因素包括入院时意识障碍、神经影像学异常结果以及脑脊液中葡萄糖含量低和总蛋白浓度高。

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