Ndiaye M M, Diagana M, Diop A G, Thiam A, Diagne M, Ndiaye I P
Clinique Neurologique, C.H.U. de Fann, Dakar.
Dakar Med. 1990;35(1):120-5.
Epilepsy over the age of 50 years represents 14% of the persons hospitalized in this age group, and 32% of all epileptics hospitalized at Dakar U. H. C. The etiologies of these epilepsies reveal 8.30% metabolic encephalopathics, and 3.35% diabetics. Between 1970 and 1988, 30 cases associating epilepsy and diabetes--of which 16 cases of epilepsy following diabetes in subjects aged over 50 years--were recorded. This association is characterized by: 1. on the biographic level: both sexes are equally concerned (7 men and 9 women); the average age is 63 years. 2. on the clinical level: partial, focal attacks dominate, accounting for 14 of the 16 cases (87.5%) and appear as a state of epileptic sickness or as recurrent attacks in 15 cases out of 16 with electro-clinical concordancy. Post-critical neurological examination is normal in 75% of the cases. 3. on the biological level: initial glycemia is more than 2.5g/l in 13 cases, with glucosuria and cetonuria. 4. on the therapeutic level: the attacks resist barbiturate and benzodiazepin treatment in 80% of the cases, but the attacks diminish as the diabetes is brought under control through insulin treatment. 5. on the evolutionary level: evolution is favourable in 56.25% of the cases. Decease (7 cases) should be explained by delay in diagnosis and therapy.
50岁以上的癫痫患者占该年龄组住院患者的14%，占达喀尔大学医院所有住院癫痫患者的32%。这些癫痫的病因显示，代谢性脑病占8.30%，糖尿病占3.35%。1970年至1988年期间，记录了30例癫痫与糖尿病相关的病例，其中16例为50岁以上患者糖尿病继发癫痫。这种关联的特点是：1. 在个人信息层面：男女患病率相同（7名男性和9名女性）；平均年龄为63岁。2. 在临床层面：部分性、局灶性发作占主导，16例中有14例（87.5%）如此，且在16例中有15例表现为癫痫状态或反复发作为电-临床一致性。75%的病例在发作后神经学检查正常。3. 在生物学层面：13例患者初始血糖超过2.5g/l，伴有糖尿和酮尿。4. 在治疗层面：80%的病例发作对巴比妥类和苯二氮䓬类治疗有抵抗，但随着糖尿病通过胰岛素治疗得到控制，发作减少。5. 在病情发展层面：56.25%的病例病情发展良好。死亡（7例）应归因于诊断和治疗延误。
