Zhou Bo, Huang Yulan, Wang Jinyu, Zou Zhili, Chen Lei, Li Jingmei, Zhou Dong
Department of Neurology, Sichuan Provincial People's Hospital, Chengdu 610041, PR China.
Department of Psychosomatic, Sichuan Provincial People's Hospital, Chengdu 610041, PR China.
Seizure. 2014 Oct;23(9):717-21. doi: 10.1016/j.seizure.2014.05.015. Epub 2014 Jun 5.
To investigate the characteristics of the aetiologies of convulsive status epilepticus (CSE) in Western China and to identify the relationships of these aetiologies with the prognoses.
Consecutive registration and prospective observation of 258 cases of CSE in the Sichuan Epilepsy Center were performed from 1996 to 2010 to study the aetiology of CSE. The relationships of the aetiologies with the demographics, outcomes and complications of CSE were analysed using a logistic regression model.
The mean age was 37.6 ± 20.21 years. The majority of the CSE (62.4%) cases were acute symptomatic cases, and the primary cause was central nervous system (CNS) infection (33.7%). Histories of epilepsy were present in 51.9% of the patients. Pre-existing epilepsy occurred due to discontinuation or reduction of antiepileptic drugs (AEDs) in 31.3% of the CSE patients. Anoxia/poisoning (p<0.05, OR 8.0, 95% CI 1.34-47.77) was an independent predictor of mortality. CNS infections (p<0.001, OR 8.99, 95% CI 3.52-22.92), cerebrovascular diseases (p =0.001, OR 6.75, 95% CI 2.11-21.61) and anoxia/poisoning (p<0.01, OR 7.64, 95% CI 1.93-30.21) were the major risk factors for complications associated with CSE.
(1) Compared to developed countries, CNS infections seemed to be more likely to be the cause of CSE in developing countries. (2) Noncompliance with AEDs among patients with epilepsy was a prominent and avoidable trigger of CSE.
探讨中国西部惊厥性癫痫持续状态（CSE）的病因特点，并确定这些病因与预后的关系。
1996年至2010年对四川癫痫中心258例CSE患者进行连续登记和前瞻性观察，以研究CSE的病因。采用逻辑回归模型分析病因与CSE的人口统计学、结局及并发症之间的关系。
平均年龄为37.6±20.21岁。大多数CSE病例（62.4%）为急性症状性病例，主要病因是中枢神经系统（CNS）感染（33.7%）。51.9%的患者有癫痫病史。31.3%的CSE患者既往癫痫发作是由于停用或减少抗癫痫药物（AEDs）所致。缺氧/中毒（p<0.05，OR 8.0，95%CI 1.34 - 47.77）是死亡的独立预测因素。CNS感染（p<0.001，OR 8.99，95%CI 3.52 - 22.92）、脑血管疾病（p = 0.001，OR 6.75，95%CI 2.11 - 21.61）和缺氧/中毒（p<0.01，OR 7.64，95%CI 1.93 - 30.21）是与CSE相关并发症的主要危险因素。
（1）与发达国家相比，发展中国家CNS感染似乎更易成为CSE的病因。（2）癫痫患者不遵医嘱服用AEDs是CSE一个突出且可避免的触发因素。
