Department of Pediatrics, Tuen Mun Hospital, Hong Kong, China.
Pediatr Neurol. 2010 Jun;42(6):417-21. doi: 10.1016/j.pediatrneurol.2010.02.010.
This study sought to evaluate seizure-related injuries in children under age 18 years with newly diagnosed epilepsy presenting at the Department of Pediatrics, Tuen Mun Hospital, in 2002-2003. All children were interviewed before January 2005. Children with seizure-related injuries were compared with those without injuries for identification of risk factors. One hundred and twenty-two children were surveyed. No patient died during a seizure. Eleven (9%) children manifested seizure-related injuries. Injury occurred at a mean age of 11.6 years, and epilepsy was diagnosed at a mean age of 13.8 years, in those with seizure-induced injuries. Injury occurred at first seizure presentation or upon diagnosis of epilepsy in 72.7% patients. Ten (90.9%) children were not receiving antiepileptic drugs at their time of injury. The mean age of seizure onset was 10.7 years in patients with injuries, and 6.7 years in control subjects (P = 0.007). Seizures resulting in injuries were generalized tonic-clonic in 72.7% (P = 0.045; odds ratio, 3.77; 95% confidence interval, 0.95-14.98). Idiopathic etiology was evident in 54.5%, and normal neurodevelopmental status in 72.7%, of patients with injuries. Age of seizure onset was the only independent variable retained after multivariate analysis. Soft-tissue and dental injuries comprised 91.7% and 75%, respectively, of injuries occurring at home. The risk of seizure-related injuries was substantial, especially before epilepsy was diagnosed, but most of these injuries were minor. These unique data could help in parental counseling.
本研究旨在评估 2002-2003 年于屯门医院儿科新诊断为癫痫的 18 岁以下儿童的与癫痫发作相关的损伤。所有儿童均于 2005 年 1 月前接受访谈。将有癫痫发作相关损伤的儿童与无损伤的儿童进行比较,以确定危险因素。共调查了 122 名儿童。没有儿童在癫痫发作时死亡。11 名(9%)儿童出现与癫痫发作相关的损伤。有损伤的儿童的损伤发生年龄平均为 11.6 岁,癫痫诊断年龄平均为 13.8 岁。72.7%的患者在首次癫痫发作或癫痫诊断时发生损伤。10 名(90.9%)儿童在受伤时未服用抗癫痫药物。有损伤的儿童的癫痫发作起始年龄为 10.7 岁,对照组为 6.7 岁(P=0.007)。导致损伤的癫痫发作中,全面强直阵挛性发作占 72.7%(P=0.045;优势比,3.77;95%置信区间,0.95-14.98)。有损伤的儿童中,特发性病因占 54.5%,神经发育正常占 72.7%。多变量分析后,仅有癫痫发作起始年龄是保留的独立变量。家中发生的损伤中,软组织损伤和牙齿损伤分别占 91.7%和 75%。与癫痫发作相关的损伤风险很大,尤其是在癫痫未确诊之前,但大多数损伤都很轻微。这些独特的数据有助于为家长提供咨询。