Rosenthal R H, Heim M L, Waeckerle J F
Ann Emerg Med. 1980 May;9(5):242-5. doi: 10.1016/s0196-0644(80)80379-9.
A five-year retrospective study was conducted to review 91 emergency patients with first time major motor seizures who were hospitalized. Patients were reviewed with regard to etiology of seizures, evaluation, and hospital course. Our objectives were to compare admission and discharge diagnoses, to establish a screening survey which might determine the need for immediate admission, and to evaluate the sensitivity of tests used in diagnostic evaluation. The emergency department diagnosis was in agreement with the discharge diagnosis in 89% of cases. A screening system included a history, physical examination, urinalysis, complete blood cell count, electrolytes, blood urea nitrogen, glucose, electrocardiogram, and arterial blood gases more than one hour post-seizure. When applied to the cases, it distinguished need for admission in 90 of 91 patients. Skull radiographs, electroencephalograms, CAT scans, brain scans, and lumbar punctures were helpful in making a specific diagnosis, but not in determining the need for immediate admission.
进行了一项为期五年的回顾性研究，以审查91例首次发生大发作性运动性癫痫并住院的急诊患者。对患者的癫痫病因、评估及住院过程进行了回顾。我们的目的是比较入院诊断和出院诊断，建立一项可能确定是否需要立即入院的筛查调查，并评估诊断评估中所用检查的敏感性。在89%的病例中，急诊科诊断与出院诊断一致。一种筛查系统包括癫痫发作后一小时以上的病史、体格检查、尿液分析、全血细胞计数、电解质、血尿素氮、血糖、心电图及动脉血气分析。将该系统应用于这些病例时，它在91例患者中的90例中鉴别出了是否需要入院。颅骨X光片、脑电图、计算机断层扫描、脑部扫描及腰椎穿刺有助于作出明确诊断，但无助于确定是否需要立即入院。
