症状性癫痫的病因学分析及有关癫痫形成时间的研究

Analysis of the Etiology for Symptomatic Epilepsy and the Study on the Time for the Genesis of Epilepsy

【目的】研究症状性癫痫的病因分布，探讨癫痫形成时间的特点。【方法】调查随访重庆医科大学附属第一医院癫痫中心9200例患者，筛选出符合症状性癫痫诊断的病例共1087例，详细记录他们的病因种类、病因年龄、癫痫发病年龄等信息，然后进行分析研究。【结果】①症状性癫痫的病因依次为头外伤、高热惊厥、颅内感染、产伤、手术、新生儿缺血缺氧性脑病、脑血管疾病、脑肿瘤等，不同病因的症状性癫痫的发病年龄不同；②59．71％的症状性癫痫患者在遭受病因打击后5年内出现癫痫发作，不同病因的症状性癫痫的癫痫形成时间不同；③头外伤和高热惊厥所致的症状性癫痫的病因年龄有显著差异，它们分别发生在成熟大脑和非成熟大脑，两者导致的症状性癫痫的癫痫形成时间不同。【结论】症状性癫痫的常见病因占第一位和第二位的分别为头外伤、高热惊厥，其他依次为颅内感染、产伤、手术、新生儿缺血缺氧性脑病、脑血管疾病、脑肿瘤等，不同病因导致的症状性癫痫有不同的发病年龄；多数症状性癫痫患者出现癫痫发作是在遭受病因打击后5年内，不同病因所致症状性癫痫有不同的癫痫形成时间；头外伤和高热惊厥导致的症状性癫痫的癫痫形成时间不同，这可能与发生在成熟大脑和非成熟大脑的癫痫形成机制不同有关。

[Objective]To study the etiological distribution for symptomatic epilepsy,and to explore the characteristics of the time for the genesis of epilepsy.[Methods]More than 9200 patients with epilepsy from epilepsy center of first affiliated hospital of Chongqing medical university were investigated and followed up.A total of 1087 patients diagnosed as symptomatic epilepsy were selected.The data such as the type and age of the etiology and onset age of epilepsy were recorded in detail,and analyzed.[Results]The causes of symptom-atic epilepsy were traumatic brain inj ury,febrile seizures,intracranial infection,birth trauma,surgery,neo-natal hypoxic-ischemic encephalopathy,cerebrovascular disease and brain tumors by turns.The onset age of symptomatic epilepsy with different causes was different.Almost 59.71% patients with symptomatic epilepsy had seizure disorder within 5 years after suffering the pathogenic factors.The time for the genesis of epilepsy in symptomatic epilepsy with different causes was different.There was significant difference in the etiological age of symptomatic epilepsy caused by traumatic brain inj ury and febrile seizures which occurred in mature brain and immature brain,respectively.The time for the genesis of epilepsy in symptomatic epilepsy caused by traumatic brain inj ury and febrile seizures was different.[Conclusion]The first and second common causes of symptomatic epilepsy are traumatic brain inj ury and febrile seizures respectively,and the other causes are in-tracranial infection,birth trauma,surgery,neonatal hypoxic-ischemic encephalopathy,cerebrovascular disease and brain tumors by turns.The onset age of symptomatic epilepsy with different causes is different.Most pa-tients with symptomatic epilepsy have seizure disorder within 5 years after suffering the pathogenic factors. The time for the genesis of epilepsy in symptomatic epilepsy is different.The time for the genesis of epilepsy in symptomatic epilepsy caused by traumatic brain inj ury and febrile seizures is different,which may be associated with the different mechanism of the genesis of epilepsy occurring in mature brain and immature brain.