de la Peña P, Porta-Etessam J
Sección de Epilepsia, Hospital Universitario 12 de Octubre, Madrid, España.
Rev Neurol. 1998 Feb;26(150):256-61.
Post-traumatic epilepsy is a well-known complication of head injury (TCE). There is extensive bibliography on the subject which contains contradictory data and unanswered questions. In this paper, we review and update the literature emphasizing particularly current definitions, incidence, risk factors and evaluation of prophylactic treatment in relation to the physio-pathology. We give data of a retrospective study of the cases observed during the past 15 years in our unit, analyzing the factors which may help to predict the evolution of these crises. There is a relationship between the incidence of post-traumatic epilepsy and the severity of injury. One of the main risk factors is the presence of focal lesions, particularly haemorrhagic lesions. Prophyllactic treatment with anti-epileptic drugs is only effective during the first week in the group at risk of developing early crises. It has not been shown to be of use in preventing post-traumatic epilepsy. Other treatments, such as antioxidants, calcium antagonist and glutamate inhibitors are still only at an experimental stage.
创伤后癫痫是颅脑损伤(TCE)的一种众所周知的并发症。关于这个主题有大量的文献资料,但其中包含相互矛盾的数据和未解决的问题。在本文中,我们回顾并更新了相关文献,特别强调了当前关于创伤后癫痫的定义、发病率、危险因素以及与生理病理学相关的预防性治疗评估。我们给出了对本单位过去15年观察到的病例进行回顾性研究的数据,分析了可能有助于预测这些发作演变的因素。创伤后癫痫的发病率与损伤严重程度之间存在关联。主要危险因素之一是存在局灶性病变,尤其是出血性病变。抗癫痫药物的预防性治疗仅在有早期发作风险的组中第一周有效。尚未证明其对预防创伤后癫痫有用。其他治疗方法,如抗氧化剂、钙拮抗剂和谷氨酸抑制剂仍仅处于实验阶段。