Adachi Naoto, Kanemoto Kousuke, Muramatsu Reimi, Kato Masaaki, Akanuma Nozomi, Ito Masumi, Kawasaki Jun, Onuma Teiichi
Adachi Mental Clinic, Sapporo, Japan.
Epilepsia. 2005 Sep;46(9):1502-9. doi: 10.1111/j.1528-1167.2005.05005.x.
Status epilepticus (SE) appears to cause cognitive dysfunction as well as other serious neurologic sequelae. To confirm whether SE produces a subsequent intellectual decline, we evaluated intellectual function prospectively in adult epilepsy patients with and without SE.
Of 1,685 patients with epilepsy who underwent comprehensive neuropsychological testing in two national hospitals in Japan, 15 patients experienced an episode of SE afterward and underwent the second neuropsychological examination after the SE episode. Forty clinically matched patients with epilepsy, but without an episode of SE since their initial neuropsychological examination, were also reevaluated. We compared IQs and subscores from the Wechsler Adult Intelligence Scale-Revised between the two groups by repeated measures analysis of variance. In the patients who experienced an SE episode, SE-related variables (i.e., age at the SE episode and type and duration of SE) and epilepsy-related variables such as epilepsy type, lateralization of EEG abnormalities, the presence of mesial temporal sclerosis, and previous history of SE, were evaluated in relation to intellectual outcome.
Patients with SE, in comparison to those without SE, failed to show any significant post-SE intellectual decline. Furthermore, neither the SE-related variables nor the clinical characteristics were correlated with intellectual outcome.
Our findings suggest that SE does not lead to a significant intellectual decline in adult patients receiving treatment for epilepsy.
癫痫持续状态（SE）似乎会导致认知功能障碍以及其他严重的神经后遗症。为了确定SE是否会导致随后的智力衰退，我们对有和没有SE的成年癫痫患者的智力功能进行了前瞻性评估。
在日本两家国立医院接受全面神经心理学测试的1685例癫痫患者中，有15例随后经历了SE发作，并在SE发作后接受了第二次神经心理学检查。另外还对40例临床匹配的癫痫患者进行了重新评估，这些患者自初次神经心理学检查后未发生SE发作。我们通过重复测量方差分析比较了两组之间韦氏成人智力量表修订版的智商和子分数。在经历过SE发作的患者中，评估了与SE相关的变量（即SE发作时的年龄以及SE的类型和持续时间）以及与癫痫相关的变量，如癫痫类型、脑电图异常的定位、内侧颞叶硬化的存在以及既往SE病史，以了解其与智力结果的关系。
与没有SE的患者相比，有SE的患者在SE发作后并未出现任何明显的智力衰退。此外，与SE相关的变量和临床特征均与智力结果无关。
我们的研究结果表明，SE不会导致接受癫痫治疗的成年患者出现明显的智力衰退。
