发作后精神病：一项包含20例患者和150例对照的病例对照研究系列。

Postictal psychosis: a case control series of 20 patients and 150 controls.

作者信息

Devinsky O, Abramson H, Alper K, FitzGerald L S, Perrine K, Calderon J, Luciano D

机构信息

Department of Neurology, NYU School of Medicine, Hospital for Joint Diseases, New York 10003, USA.

出版信息

Epilepsy Res. 1995 Mar;20(3):247-53. doi: 10.1016/0920-1211(94)00085-b.

DOI:10.1016/0920-1211(94)00085-b

PMID:7796797

Abstract

We compared clinical data, EEG, and video-EEG studies in a consecutive series of 20 patients with postictal psychosis (PP) to 150 consecutive epilepsy patients with complex partial (CPS) or generalized tonic-clonic (GTCS) seizures but without PP. There was a lucid interval between last seizure and onset of psychosis ranging from 2.3 to 72 h (mean, 25 h). Duration of PP ranged from 16 to 432 h (mean, 83 h). Age, sex, epilepsy type (partial vs. generalized), and history of febrile seizures were similar in the PP and control groups. Patients with PP had more frequent GTCS during monitoring than controls (2.8 vs. 1.3; P < 0.001). Patients with PP were more likely to have a history of encephalitis (P < 0.0001) and psychiatric hospitalization (P < 0.002). More patients with PP had bilateral interictal epileptiform discharges during monitoring than controls (P < 0.0002). Postictal psychosis most often develops in patients with bilateral dysfunction following a cluster of GTCS.

摘要

我们将连续纳入的20例癫痫发作后精神病（PP）患者的临床数据、脑电图（EEG）及视频脑电图研究结果，与连续纳入的150例患有复杂部分性发作（CPS）或全身强直阵挛性发作（GTCS）但无PP的癫痫患者进行了比较。末次发作至精神病发作的清醒期为2.3至72小时（平均25小时）。PP的持续时间为16至432小时（平均83小时）。PP组和对照组在年龄、性别、癫痫类型（部分性发作与全身性发作）及热性惊厥病史方面相似。监测期间，PP患者的GTCS发作频率高于对照组（2.8次对1.3次；P<0.001）。PP患者更可能有脑炎病史（P<0.0001）及精神科住院史（P<0.002）。监测期间，PP患者出现双侧发作间期癫痫样放电的人数多于对照组（P<0.0002）。癫痫发作后精神病最常发生于一组GTCS发作后出现双侧功能障碍的患者。