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台湾地区儿童惊厥性癫痫持续状态分析。

Analysis of convulsive status epilepticus in children of Taiwan.

机构信息

Division of Pediatric Neurology, Chang Gung Children's Hospital and Chang Gung Memorial Hospital, Chang Gung University College of Medicine, #5 Fu-Shin Street, Kwei-Shan, Taoyuan 333, Taiwan.

出版信息

Pediatr Neurol. 2009 Dec;41(6):413-8. doi: 10.1016/j.pediatrneurol.2009.06.004.

Abstract

Convulsive status epilepticus is a medical emergency with significantly associated mortality and morbidity. The demographic data and outcomes of convulsive status epilepticus in children were collected for descriptive analysis. We retrospectively reviewed cases of convulsive status epilepticus in the Pediatric Intensive Care Unit of Chang Gung Children's Hospital between 1999 and 2006. We enrolled 141 patients with 198 episodes of convulsive status epilepticus, aged 2 months to 18 years: 24.8% of first episodes developed convulsive status epilepticus, with a duration of over 60 minutes. First episodes of convulsive status epilepticus were most often evidenced in febrile status during acute central nerve system infections (48.2%), and in nonfebrile status during acute noncentral nerve system illness in previously epileptic children (28.4%). Before their first episode, 63.8% of children were neurologically healthy, and 12.2% exhibited a prolonged febrile seizure. The most common etiology of mortality was acute central nervous system infection. The immediate mortality rate was 7.1%. Convulsive status epilepticus in childhood is more common, with a different range of causes and a lower risk of death, than convulsive status epilepticus in adults. Acute central nervous system infections appear to be markers for morbidity and mortality.

摘要

惊厥性癫痫持续状态是一种具有显著死亡率和发病率的医学急症。我们收集了儿童惊厥性癫痫持续状态的人口统计学数据和结局进行描述性分析。我们回顾性分析了 1999 年至 2006 年期间长庚儿童医院儿科重症监护病房的惊厥性癫痫持续状态病例。共纳入 141 例患者,198 例出现惊厥性癫痫持续状态,年龄为 2 个月至 18 岁:24.8%的首次发作出现惊厥性癫痫持续状态,持续时间超过 60 分钟。首次惊厥性癫痫持续状态发作最常发生在急性中枢神经系统感染的热性惊厥状态(48.2%),以及在以前有癫痫的儿童急性非中枢神经系统疾病的非热性惊厥状态(28.4%)。在首次发作前,63.8%的儿童神经功能正常,12.2%表现为热性惊厥持续时间延长。死亡率最高的病因是急性中枢神经系统感染。即刻死亡率为 7.1%。儿童惊厥性癫痫持续状态比成人更常见,病因范围不同,死亡风险较低。急性中枢神经系统感染似乎是发病率和死亡率的标志物。

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