2. Neurologische Abteilung, Krankenhaus Hietzing mit Neurologischem Zentrum Rosenhügel, Vienna, Austria.
Department of Neurology, Christian-Doppler-Klinik, Paracelsus Medical University, Salzburg, Austria.
Eur J Neurol. 2013 Mar;20(3):429-439. doi: 10.1111/j.1468-1331.2012.03842.x. Epub 2012 Sep 4.
Epilepsy is a frequent complication of central nervous system (CNS) infections. Post-infectious epilepsy is commonly refractory to medical treatment and plays a pivotal role for the poor long-term outcome of CNS infections.
To provide an overview of clinical characteristics and risk factors of seizures associated with CNS infections. In addition, to summarize the state of the art of anticonvulsive treatment and the pre-surgical evaluation process in refractory cases.
A comprehensive literature search for articles published between January 1970 and December 2011 was carried out.
The occurrence of seizures during the acute course of meningitis, encephalitis and brain abscess is the main risk factor for the development of post-infectious epilepsy. There is a shortage of trials evaluating the efficacy of prophylactic and symptomatic treatment during the course of acute infection. Moreover, there are no randomized-controlled trials studying anticonvulsive drugs and their combinations for the management of post-infectious epilepsy. In a selected group of patients, however, medically refractory focal epilepsy is potentially curable by surgery.
Further studies are required to improve the pathogenetic understanding of post-infectious epilepsy in order to develop preventive measures as well as to evaluate additional medical and surgical treatment strategies for the patients currently not considered for surgery.
癫痫是中枢神经系统（CNS）感染的常见并发症。感染后癫痫通常对药物治疗有抗性，对 CNS 感染的长期预后有重要影响。
综述 CNS 感染相关癫痫发作的临床特征和危险因素。此外，总结难治性癫痫的抗惊厥治疗和术前评估过程的最新进展。
对 1970 年 1 月至 2011 年 12 月间发表的文章进行了全面的文献检索。
在脑膜炎、脑炎和脑脓肿的急性病程中出现癫痫发作是发生感染后癫痫的主要危险因素。目前缺乏评估急性感染期间预防性和症状性治疗效果的临床试验。此外，也没有研究抗惊厥药物及其联合用药治疗感染后癫痫的随机对照试验。然而，对于某些特定患者，经药物治疗无效的局灶性癫痫可以通过手术治愈。
需要进一步的研究来提高对感染后癫痫的发病机制的认识，以便制定预防措施，并评估目前不适合手术的患者的其他治疗策略。
