7例未明确诊断患者癫痫样发作致交通事故分析

Analysis of traffic accidents caused by epileptic seizures in 7 patients without definite diagnosis

目的阐明未明确诊断的癫痫患者驾驶机动车时出现痫性发作这一不容忽视的现象及其危害。方法回顾性调查2020年1月至2022年6月在苏州大学附属第一医院就诊、因痫性发作引发交通事故的癫痫患者,并对其人口学资料、交通事故相关信息和癫痫诊治情况进行汇总分析。结果共收集7例成人癫痫患者资料,其中男性6例,4例患者驾龄大于10年。其中1例驾驶的车辆为公交车,其余6例均驾驶私家车。5/7的事故有人员受伤,3/7的事故造成人员死亡。有5例患者脑电图结果提示发作间期癫痫样放电;有2例患者影像学检查结果提示可能导致癫痫发作的大脑皮质病灶。在发作形式上,有3例患者为局灶进展至全面性发作,其余4例为局灶性发作伴意识障碍可能性大。结论未明确诊断的癫痫患者痫性发作导致交通事故,危害患者自身和公共安全,需要引起医患双方乃至全社会的重视。

Objective To elucidate the phenomenon that epileptic seizure occurs in patients with epilepsy without definite diagnosis when driving a motor vehicle and its hazards.Methods From January 2020 to June 2022,7 epileptic patients who experienced traffic accidents caused by seizures were selected from the First Affiliated Hospital of Soochow University,and their demographic data,traffic accident related data and epilepsy diagnosis and treatment data were summarized and analyzed.Results A total of 7 adult patients with epilepsy were collected,including 6 males,4 of whom had been driving for more than 10 years.Among them,1 patient drove a bus,and the other 6 patients drove private cars.Totally 5/7 of the accidents resulted in personal injury,and 3/7 of the accidents resulted in personal death.In 5 patients,video electroencephalogram showed interictal epileptiform discharges.In 2 patients,the imaging findings suggested the presence of cerebral cortical lesions that may lead to seizures.In terms of the form of seizure,3 patients′seizure type was focal to bilateral tonic-clonic,and the other 4 patients were very probable to be focal impaired awareness seizure.Conclusions Undiagnosed epileptic seizures lead to traffic accidents,endanger patients and public safety,which need to attract attention from both doctors and patients,as well as the whole society.