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钙化性实质型中枢神经系统囊尾蚴病与癫痫的临床结局

Calcified parenchymal central nervous system cysticercosis and clinical outcomes in epilepsy.

作者信息

Leon Amanda, Saito Erin K, Mehta Bijal, McMurtray Aaron M

机构信息

Pitzer College, Claremont, CA, USA.

Neurology Division, Los Angeles Biomedical Research Institute, Torrance, CA, USA.

出版信息

Epilepsy Behav. 2015 Feb;43:77-80. doi: 10.1016/j.yebeh.2014.12.015. Epub 2015 Jan 5.

DOI:10.1016/j.yebeh.2014.12.015
PMID:25569744
Abstract

OBJECTIVE

This study aimed to compare clinical outcomes including seizure frequency and psychiatric symptoms between patients with epilepsy with neuroimaging evidence of past brain parenchymal neurocysticercosis infection, patients with other structural brain lesions, and patients without structural neuroimaging abnormalities.

MATERIAL AND METHODS

The study included retrospective cross-sectional analysis of all patients treated for epilepsy in a community-based adult neurology clinic during a three-month period.

RESULTS

A total of 160 patients were included in the analysis, including 63 with neuroimaging findings consistent with past parenchymal neurocysticercosis infection, 55 with structurally normal brain neuroimaging studies, and 42 with other structural brain lesions. No significant differences were detected between groups for either seizure freedom (46.03%, 50.91%, and 47.62%, respectively; p=0.944) or mean seizure frequency per month (mean=2.50, S.D.=8.1; mean=4.83, S.D.=17.64; mean=8.55, S.D.=27.31, respectively; p=0.267). Self-reported depressive symptoms were more prevalent in those with parenchymal neurocysticercosis than in the other groups (p=0.003). No significant differences were detected for prevalence of self-reported anxiety or psychotic symptoms.

CONCLUSIONS

Calcified parenchymal neurocysticercosis results in refractory epilepsy about as often as other structural brain lesions. Depressive symptoms may be more common among those with epilepsy and calcified parenchymal neurocysticercosis; consequently, screening for depression may be indicated in this population.

摘要

目的

本研究旨在比较有脑实质神经囊尾蚴病既往感染神经影像学证据的癫痫患者、有其他脑结构病变的患者以及无神经影像学结构异常的患者之间的临床结局,包括癫痫发作频率和精神症状。

材料与方法

本研究对一家社区成人神经病学诊所三个月期间接受癫痫治疗的所有患者进行回顾性横断面分析。

结果

共有160例患者纳入分析,其中63例神经影像学检查结果符合既往脑实质神经囊尾蚴病感染,55例脑结构神经影像学检查正常,42例有其他脑结构病变。各组在癫痫发作缓解率(分别为46.03%、50.91%和47.62%;p = 0.944)或每月平均癫痫发作频率(分别为均值 = 2.50,标准差 = 8.1;均值 = 4.83,标准差 = 17.64;均值 = 8.55,标准差 = 27.31;p = 0.267)方面均未检测到显著差异。自我报告的抑郁症状在脑实质神经囊尾蚴病患者中比其他组更普遍(p = 0.003)。自我报告的焦虑或精神病性症状患病率未检测到显著差异。

结论

钙化性脑实质神经囊尾蚴病导致难治性癫痫的频率与其他脑结构病变大致相同。抑郁症状在患有癫痫和钙化性脑实质神经囊尾蚴病的患者中可能更常见;因此,该人群可能需要进行抑郁筛查。

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