Shatirishvili T, Tatishvili N, Lomidze G, Kipiani T
D. Tvildiani Medical University; M. Iashvili Children Central Hospital, Tbilisi, Georgia.
Georgian Med News. 2014 Jun(231):60-3.
CSE is the most common childhood neurological emergency in developed countries, which can lead to neuro cognitive sequel and death with different hazards and outcome. The majority of authors'agreed that etiology is the main determinant of morbidity, but different studies reported different etiology groups as predictors of the poor outcome. Present study was conducted to evaluate predictive value of etiology in post CSE morbidity. Prospective, hospital-based study was performed in Tbilisi. Patients, aged from one month to 18 years with CSE, admitted to the emergency department of M. Iashvili Children's Central Hospital from March 2007 to March 2012 were included. The short-term outcome of CSE was evaluated after 30 days from admission and it was classified into three categories: unchanged neurologic status, neurological consequences (new neurologic deficit compared to the condition before CSE), and lethal outcome. 48 children aged one month- 18 years were analyzed. In our study acute symptomatic, remote symptomatic and progressive encephalopathy were associated with higher morbidity. Progressive encephalopathy is the most frequent etiology group which led to develop new neurological sequel after CSE and long duration of CSE. According to our data we conclude that children with idiopathic or febrile CSE have a favorable outcome. While acute symptomatic etiology group mostly was associated and statistical significant association were found with progressive encephalopathy and development morbidity after CSE. According to our data we conclude that children with idiopathic or febrile CSE have a favorable outcome. While progressive encephalopathy lead to develop morbidity after CSE.
惊厥性癫痫持续状态(CSE)是发达国家最常见的儿童神经系统急症,可导致神经认知后遗症和死亡,且具有不同的危险因素和结局。大多数作者一致认为病因是发病率的主要决定因素,但不同研究报告了不同的病因组作为不良结局的预测因素。本研究旨在评估病因对CSE后发病情况的预测价值。在第比利斯进行了一项基于医院的前瞻性研究。纳入2007年3月至2012年3月期间在M. Iashvili儿童中央医院急诊科就诊的1个月至18岁的CSE患儿。入院30天后评估CSE的短期结局,并将其分为三类:神经状态无变化、神经后果(与CSE前相比出现新的神经功能缺损)和致命结局。对48名1个月至18岁的儿童进行了分析。在我们的研究中,急性症状性、远隔症状性和进行性脑病与较高的发病率相关。进行性脑病是最常见的病因组,可导致CSE后出现新的神经后遗症以及CSE持续时间延长。根据我们的数据,我们得出结论,特发性或热性CSE患儿预后良好。而急性症状性病因组大多与CSE后进行性脑病和发病相关,且存在统计学显著关联。根据我们的数据,我们得出结论,特发性或热性CSE患儿预后良好。而进行性脑病会导致CSE后发病。