Xu Tao, Yu Xinyuan, Ou Shu, Liu Xi, Yuan Jinxian, Huang Hao, Yang Juan, He Liang, Chen Yangmei
Department of Neurology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China.
Department of Neurology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China.
Epilepsy Behav. 2017 Feb;67:1-6. doi: 10.1016/j.yebeh.2016.10.026. Epub 2017 Jan 8.
A systematic review and meta-analysis was performed to identify risk factors for posttraumatic epilepsy (PTE).
Two electronic databases (Medline and Embase) were searched to identify studies with a cohort, case-control, or cross-sectional design reporting on epidemiologic evidence regarding risk factors for PTE.
Men had a higher risk of developing PTE than women [relative ratio (RR), 1.32; 95% confidence interval (CI), 1.10-1.59]. A history of alcohol abuse (RR, 2.18; 95% CI, 1.26-3.79), posttraumatic amnesia (RR, 1.31; 95% CI, 1.12-1.53), focal neurologic signs (RR, 1.42; 95% CI, 1.16-1.74), and loss of consciousness at initial traumatic brain injury (TBI) (RR, 1.62; 95% CI, 1.13-2.32) were associated with a greater risk of PTE. TBI-related abnormal neuroimaging findings, including skull fracture (RR, 2.27; 95% CI, 1.49-3.44), midline shift (RR, 1.46; 95% CI, 1.14-1.87), brain contusion (RR, 2.35; 95% CI, 1.69-3.28), subdural hemorrhage (RR, 2.00; 95% CI, 1.33-3.01), and intracranial hemorrhage (RR, 2.65; 95% CI, 1.83-3.82) were strong risk factors for PTE. The risk of developing PTE after skull fracture, mild brain injury, and severe brain injury peaked within the first year after TBI, and then gradually decreased. However, a high risk of PTE was sustained for >10years.
The current meta-analysis identified potential risk factors for PTE. The results may contribute to better prevention strategies and treatments for PTE.
进行一项系统评价和荟萃分析，以确定创伤后癫痫（PTE）的危险因素。
检索两个电子数据库（Medline和Embase），以识别采用队列研究、病例对照研究或横断面研究设计，报告有关PTE危险因素的流行病学证据的研究。
男性发生PTE的风险高于女性[相对比（RR），1.32；95%置信区间（CI），1.10 - 1.59]。酗酒史（RR，2.18；95%CI，1.26 - 3.79）、创伤后遗忘（RR，1.31；95%CI，1.12 - 1.53）、局灶性神经体征（RR，1.42；95%CI，1.16 - 1.74）以及初始创伤性脑损伤（TBI）时的意识丧失（RR，1.62；95%CI，1.13 - 2.32）与PTE的较高风险相关。与TBI相关的异常神经影像学表现，包括颅骨骨折（RR，2.27；95%CI，1.49 - 3.44）、中线移位（RR，1.46；95%CI，1.14 - 1.87）、脑挫伤（RR，2.35；95%CI，1.69 - 3.28）、硬膜下出血（RR，2.00；95%CI，1.33 - 3.01）和颅内出血（RR，2.65；95%CI，1.83 - 3.82）是PTE的强危险因素。颅骨骨折、轻度脑损伤和重度脑损伤后发生PTE的风险在TBI后的第一年内达到峰值，然后逐渐下降。然而，PTE的高风险持续超过10年。
当前的荟萃分析确定了PTE的潜在危险因素。这些结果可能有助于制定更好的PTE预防策略和治疗方法。
