Division of Pediatric Neurology, Chang Gung Children's Hospital, Chang Gung University College of Medicine, Taoyuan, Taiwan.
Pediatr Neurol. 2010 Jul;43(1):41-5. doi: 10.1016/j.pediatrneurol.2010.02.017.
Encephalitis is characterized clinically by fever, seizure, and an altered level of consciousness. Mycoplasma pneumoniae, a common respiratory pathogen, has been implicated as an etiology of encephalitis. The present study was designed to analyze status epilepticus associated with M. pneumoniae encephalitis in a series of children through retrospective review of cases between January 2002 and January 2008. Systematic clinical data were evaluated. Nine patients were identified: five girls and four boys, aged 4 years to 10 years. All were positive for M. pneumoniae by serology. Six of the nine children (67%) developed refractory status epilepticus. The major clinical symptoms included fever (100%) and upper respiratory symptoms (78%). The most common seizure type was primary focal with secondary generalized seizure (44%). The time of follow-up for this study ranged from 18 months to 86 months. At the end of the study period, two patients had died, seven had developed epilepsy or neurologic deficits, and none had returned to baseline. These data indicate that children with status epilepticus associated with M. pneumoniae encephalitis have high mortality and morbidity. Clinicians should be aware of the potential role of M. pneumoniae in status epilepticus.
脑炎的临床特征为发热、癫痫发作和意识水平改变。肺炎支原体是一种常见的呼吸道病原体,已被认为是脑炎的病因之一。本研究旨在通过回顾性分析 2002 年 1 月至 2008 年 1 月期间的病例,分析一系列儿童中与肺炎支原体脑炎相关的癫痫持续状态。系统性临床数据进行了评估。确定了 9 例患者:5 名女孩和 4 名男孩,年龄 4 至 10 岁。所有患者的血清学检测均为肺炎支原体阳性。9 例患儿中有 6 例(67%)发生难治性癫痫持续状态。主要临床症状包括发热(100%)和上呼吸道症状(78%)。最常见的癫痫发作类型为原发性局灶性伴继发性全面性发作(44%)。本研究的随访时间为 18 个月至 86 个月。在研究结束时,2 例患者死亡,7 例患者出现癫痫或神经功能缺损,无患者恢复到基线水平。这些数据表明,与肺炎支原体脑炎相关的癫痫持续状态患儿死亡率和发病率较高。临床医生应意识到肺炎支原体在癫痫持续状态中的潜在作用。