Rosenberg N M, Meert K, Marino D, De Baker K
Department of Pediatrics, Children's Hospital of Michigan, Detroit 48201.
Pediatr Emerg Care. 1992 Apr;8(2):67-9. doi: 10.1097/00006565-199204000-00002.
The records of 187 patients with bacterial meningitis were reviewed. Seizures were a presenting manifestation in 25 (13%). Seven (28%) of the patients with a presenting seizure had been taking antibiotics prior to the diagnosis. Four of seven pretreated patients did not have additional signs or symptoms with the seizure, while all 18 patients without treatment had additional findings (P less than 0.01). Patients developing seizures while hospitalized had a poorer outcome than those without seizures. Patients with bacterial meningitis may present with only a seizure if they have been taking oral antibiotics; therefore, all patients taking antibiotics who develop a seizure require a lumbar puncture to exclude meningitis.
回顾了187例细菌性脑膜炎患者的记录。癫痫发作是25例（13%）患者的首发表现。25例首发癫痫发作的患者中有7例（28%）在诊断前已服用抗生素。7例预处理患者中有4例癫痫发作时没有其他体征或症状，而18例未接受治疗的患者均有其他发现（P<0.01）。住院期间发生癫痫发作的患者预后比未发生癫痫发作的患者差。如果细菌性脑膜炎患者一直在口服抗生素，可能仅表现为癫痫发作；因此，所有服用抗生素且发生癫痫发作的患者都需要进行腰椎穿刺以排除脑膜炎。
