Maegaki Y, Kurozawa Y, Hanaki K, Ohno K
Division of Child Neurology, Institute of Neurological Sciences, Faculty of Medicine, Tottori University, Yonago, Japan.
Neuropediatrics. 2005 Jun;36(3):186-92. doi: 10.1055/s-2005-865611.
Using multivariate regression analysis, we examined risk factors for fatality and neurological sequelae after status epilepticus (SE) in children. Possible risk factors included sex, age at onset, the cause of SE, pyrexia, asthmatic attack during SE, past history of seizure, predisposing neurological abnormality, seizure duration, type of seizure, and medication with theophylline. Consecutive patients with SE, aged 1 month to 18 years, who were referred to Tottori University Hospital from 1984 to 2002 were reviewed. Of the 234 patients enrolled, 45 patients (19.2 %) showed poor outcomes, namely early death in 9 and neurological sequela in 36. Acute neurological insult and progressive neurological disease as the cause of SE were very significantly related to poor outcome (OR = 33.68, p = 0.000). We excluded 21 patients with the etiology of acute neurological insult and progressive neurological disease and then reanalyzed risk factors in the remaining 213 patients. Twenty-nine patients (13.6 %) showed poor outcome, namely early death in 6 and neurological sequela in 23. Seizure duration of more than 2 hours (OR = 12.73, p = 0.000) and moderate to severe asthmatic attack (OR = 31.61, p = 0.010) were associated with poor outcome. These results indicate that long-lasting seizure activity and asthmatic attack can exacerbate SE-associated brain injury.
我们采用多变量回归分析，研究了儿童癫痫持续状态（SE）后死亡及神经后遗症的危险因素。可能的危险因素包括性别、发病年龄、SE的病因、发热、SE期间的哮喘发作、既往癫痫病史、易患神经异常、癫痫持续时间、癫痫类型以及使用茶碱治疗。回顾了1984年至2002年转诊至鸟取大学医院的1个月至18岁的连续性SE患者。在纳入的234例患者中，45例（19.2%）预后不良，其中9例早期死亡，36例有神经后遗症。作为SE病因的急性神经损伤和进行性神经疾病与不良预后密切相关（OR = 33.68，p = 0.000）。我们排除了21例急性神经损伤和进行性神经疾病病因的患者，然后对其余213例患者重新分析危险因素。29例（13.6%）预后不良，其中6例早期死亡，23例有神经后遗症。癫痫持续时间超过2小时（OR = 12.73，p = 0.000）和中度至重度哮喘发作（OR = 31.61，p = 0.010）与不良预后相关。这些结果表明，长时间的癫痫活动和哮喘发作会加重与SE相关的脑损伤。
