Alldredge B K, Lowenstein D H
Department of Neurology, University of California, San Francisco 94143-0870.
Epilepsia. 1993 Nov-Dec;34(6):1033-7. doi: 10.1111/j.1528-1157.1993.tb02130.x.
We reviewed the case records of 249 adult patients with generalized convulsive status epilepticus (SE) examined in San Francisco General Hospital between 1977 and 1989 and identified 27 patients (10.8%) in whom alcohol abuse was the only identifiable precipitating cause of SE. In 12 patients (44% of the study group), SE was the first presentation of alcohol-related seizures. Seizures with focal features were observed in 11 patients (40.1%), but there was little correlation with localized computed tomography (CT) or EEG abnormalities. SE was controlled with phenytoin (PHT), with or without a benzodiazepine (BZD), in 18 patients (66.7%). Twenty-two patients (81.5%) were discharged with no new neurologic deficits, but time to recovery of baseline mental status was prolonged (> 12 h) in 24 patients. With regard to alcohol abuse history, study patients did not differ from a comparison group with isolated alcohol withdrawal seizures. The results indicate that alcohol abuse is a common cause of SE and that SE may be the first presentation of alcohol-related seizures. Furthermore, the outcome of patients with alcohol-related SE compares favorably with that of patients with SE due to other causes, but recovery of these patients may be complicated by a prolonged postictal state.
我们回顾了1977年至1989年间在旧金山总医院接受检查的249例成人全面性惊厥性癫痫持续状态（SE）患者的病例记录，确定了27例（10.8%）患者，其中酒精滥用是唯一可识别的SE促发原因。在12例患者（占研究组的44%）中，SE是酒精相关性癫痫发作的首次表现。11例患者（40.1%）观察到有局灶性特征的发作，但与局部计算机断层扫描（CT）或脑电图异常几乎没有相关性。18例患者（66.7%）使用苯妥英（PHT）控制SE，无论是否联合使用苯二氮䓬类药物（BZD）。22例患者（81.5%）出院时无新的神经功能缺损，但24例患者恢复至基线精神状态的时间延长（>12小时）。关于酒精滥用史，研究患者与单纯酒精戒断性癫痫发作的对照组没有差异。结果表明，酒精滥用是SE的常见原因，且SE可能是酒精相关性癫痫发作的首次表现。此外，酒精相关性SE患者的预后与其他原因导致的SE患者相比良好，但这些患者的恢复可能因发作后状态延长而复杂化。
