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恙虫病中的癫痫持续状态。

Status epilepticus in scrub typhus.

作者信息

Kalita Jayantee, Mani Vinita E, Bhoi Sanjeev K, Misra Usha K

机构信息

Department of Neurology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India.

出版信息

Epilepsia. 2016 Jul;57(7):e125-8. doi: 10.1111/epi.13412. Epub 2016 May 24.

Abstract

Scrub typhus is an emerging infection, and there is little information about status epilepticus (SE) in scrub typhus. We report the clinical spectrum and outcome of SE in scrub typhus. In a 3-year prospective hospital-based observational study, all scrub typhus patients with SE were included. Scrub typhus was diagnosed by immunochromatography assay. SE was defined if convulsions lasted longer than 5 min. The patients' demographic, clinical, computed tomography (CT), magnetic resonance imaging (MRI), and electroencephalography (EEG) findings were noted. Response to antiepileptic drugs (AEDs) and outcome at 1 month and 1 year were recorded. Between 2012 and 2014, there were 66 patients with scrub typhus admitted with central nervous system (CNS) involvement, 10 (15.2%) of whom had SE (generalized convulsions in 5, secondary generalized in one). The median age of the patients was 34 (range 18-71) years and seven were female. The duration of SE ranged between 10 min and 48 h. SE responded to one AED in five patients, two AEDs in three patients, and more than two AEDs in two patients. Cranial MRI findings were normal. All patients recovered completely with doxycycline by 1 month and AED was withdrawn by 8 months in all. Although 15% patients with scrub typhus may have SE, they have good outcome.

摘要

恙虫病是一种新发传染病,关于恙虫病中癫痫持续状态(SE)的信息很少。我们报告了恙虫病中SE的临床谱及转归。在一项为期3年的基于医院的前瞻性观察性研究中,纳入了所有患有SE的恙虫病患者。通过免疫层析法诊断恙虫病。如果惊厥持续超过5分钟则定义为SE。记录患者的人口统计学、临床、计算机断层扫描(CT)、磁共振成像(MRI)和脑电图(EEG)检查结果。记录对抗癫痫药物(AEDs)的反应以及1个月和1年时的转归。2012年至2014年期间,有66例恙虫病患者因中枢神经系统(CNS)受累入院,其中10例(15.2%)发生SE(5例全身性惊厥,1例继发性全身性惊厥)。患者的中位年龄为34岁(范围18 - 71岁),7例为女性。SE的持续时间在10分钟至48小时之间。5例患者对一种AED有反应,3例患者对两种AED有反应,2例患者对两种以上AED有反应。头颅MRI检查结果正常。所有患者在1个月时使用强力霉素完全康复,所有患者在8个月时停用AED。尽管15%的恙虫病患者可能发生SE,但他们的转归良好。

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