病毒性脑炎癫痫发作的临床特点及预后分析

CLINICAL FEATURES AND PROGNOSIS OF SEIZURE AFTER VIRAL ENCEPHALITIS

目的探讨病毒性脑炎急性期与非急性期继发癫痫病人的临床特点及预后,为病毒性脑炎继发癫痫,尤其是非急性期继发癫痫病人的诊治提供理论指导。方法选取病毒性脑炎继发癫痫病人159例,按癫痫在病毒性脑炎病程中发作时间分为两组,急性期组病人109例,非急性期组病人50例。对两组病人的一般情况、临床特点及预后情况进行比较。结果两组病人在发病年龄、性别、发病前是否有上呼吸道感染史方面等差异无显著意义(P>0.05)。急性期组病人癫痫较非急性期组发作频繁(χ2=16.511,P<0.05);急性期组病人预后优于非急性期组(χ2=28.079,P<0.05),非急性期组病人发展为难治性癫痫概率明显高于急性期组(χ2=130.137,P<0.05)。结论虽然病毒性脑炎急性期继发癫痫较非急性期继发癫痫发作频繁,但其预后较好;非急性期继发癫痫病人更易发展为难治性癫痫,有必要对病毒性脑炎继发癫痫进行积极治疗。

Objective To investigate the clinical features and prognosis of patients with secondary epilepsy during the acute and non-acute stages of viral encephalitis（VE）,and to provide a theoretical basis for the diagnosis and treatment of epilepsy secondary to VE,especially in the non-acute stage. Methods A total of 159 patients with epilepsy secondary to VE were enrolled,and according to the onset time of epilepsy during the course of VE,the patients were divided into acute group with 109 patients and non-acute group with 50 patients.The two groups were compared in terms of general status,clinical features,and prognosis. Results There were no significant differences between the two groups in age,sex,and the history of upper respiratory infections before the onset of VE（P〈0.05）.Compared with the non-acute group,the acute group had a significantly higher frequency of epileptic seizures（χ~2=16.511,P〈0.05）and significantly better prognosis（χ~2=28.079,P〈0.05）.The non-acute group had a significantly higher possibility of progression to intractable epilepsy than the acute group（χ~2=130.137,P〈0.05）.Conclusion Although the frequency of epileptic seizures in the acute stage of VE is higher than that in the non-acute stage,epilepsy in the acute stage tends to have better prognosis.Patients with epilepsy in the non-acute stage of VE tend to progress to intractable epilepsy,and therefore,active treatment is necessary for epilepsy secondary to VE.