外伤性癫痫危险因素分析

Analysis of risk factors of posttraumatic epilepsy

目的 调查颅脑创伤（TBI）患者外伤性癫痫（PTE）的发生率、发作类型、危险因素及其认知功能等。方法对我院脑系科中心2004年9月至2007年9月之间好转出院的TBI病例进行回顾性调查和电话随访及回访。纳入资料完整及能随访的患者共2023例。结果（1）2023例TBI患者中有98例出现PTE，其发生率为4．84％，高发年龄段为51～70岁和10岁以下。65例（66．32％）患者的PTE发生于外伤后1年以内；（2）TBI病情重、高龄、皮层损伤、蛛网膜下腔出血、多次手术治疗及受伤早期痫性发作均可增加PTE的发病率；（3）PTE患者认知障碍和性格发生变化的发生率高于非PTE患者（P〈0．05）。结论癫痫发生与TBI严重程度、受伤年龄、损伤部位、影像学表现、治疗方法和伤后临床表现等有关。

Objective The purpose of this study was to investigate the incidence of posttraumatic seizure and epilepsy, the seizure type of epilepsy, risk factors of epilepsy and Recognition function. Methods The TBI cases discharged after the improvement from September 2004 to September 2007 were retrospectively investigated and visited by telephone and 2 023 cases was brought into study. Results （ 1 ） 98 cases suffered FFE and the incidence of PTE was 4. 84% ; the age of high incidence was 51 -70 years old and less than 10 years old. 65 cases （66. 32% ） occurred in less than one year after trauma. （2） Serious injury, old age, cortical injury, subarachnoid hemorrhage, many surgical treatment and early epileptic seizure after injury would increase the incidence of PTE （ P 〈 0. 05 ） . （ 3 ） The incidence of cognitive impairment was higher in patients with PTE than non - PTE patients （ P 〈 0. 05 ）. Conclusion The risk of posttraumatic seizure and epilepsy is correlation with the severity of TBI, age, injury location, imaging findings, treatment methods and clinical manifestations after injury.