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排序方式: 共有1573条查询结果,搜索用时 46 毫秒
1.
Remission of Seizures and Relapse in Patients with Epilepsy   总被引:47,自引:47,他引:29  
In a longitudinal study of patients with epilepsy in Rochester, Minnesota, we found that the probability of being in remission (at least 5 consecutive years seizure-free, and continuing) at 20 years after diagnosis was 70%. The rates for remission we encountered were generally higher than those previously reported. We believe that the better prognosis in our series results from inclusion of all incidence cases in a defined population, beginning at the initial diagnosis of epilepsy. Prognosis for remission of epilepsy is poor in patients with associated neurologic dysfunction identified from birth. Patients with idiopathic seizures and survivors of postnatally acquired epilepsy have better prospects for eventual remission. The probability of remission is highest in patients with generalized-onset seizures diagnosed before 10 years of age. Prognosis is less favorable for those with partial complex seizures and adult-onset epilepsy.  相似文献
2.
Determinants of Mortality in Status Epilepticus   总被引:26,自引:26,他引:10  
Summary: Using univariate and multivariate regression analysis, we studied seizure duration, seizure type, age, etiologies, other clinical features, and mortality among 253 adults with status epilepticus (SE) admitted to the Medical College of Virginia. Cerebral vascular disease and discontinuation of antiepileptic drugs (AEDs) were the most prominent causes of SE, each accounting for ∼22% of all patients in the series. The other principle etiologies were alcohol withdrawal, idiopathic, anoxia, metabolic disorders, hemorrhage, infection, tumor, drug overdose, and trauma. When the patients were divided into two groups, the group with SE lasting < 1 h had a lower mortality as compared with seizure duration ≥ 1 h. Low mortality rates were noted in alcohol and AED discontinuation etiologies. Anoxia and increasing age were significantly correlated with higher mortality. The mortality rates of partial and generalized SE were not significantly different. Race and sex did not affect mortality significantly. Our findings represent the first multivariate analysis of predictive indicators of mortality in SE and demonstrate that specific factors influence mortality rate in SE.  相似文献
3.
Natural History of Epileptic Seizures   总被引:23,自引:23,他引:4  
Since 1963 a continuous registration of patients with epileptic seizures has been carried out in Greater Aarhus, Denmark. This registration has been attempted by means of medical records dating back to 1940. On the basis of the established prevalence and the calculated cumulated incidence, we have tried to describe the natural history of the different types of epilepsy. The prevalence of all types of epileptic seizures (including febrile convulsions) has been found to be 2,441/100,000, whereas for patients with the diagnosis of epilepsy the rate is 1,274/100,000. The study describes the natural history of the different types of epilepsy. In addition, the risk-increasing effect of a febrile convulsive seizure on the development of epilepsy is analyzed.  相似文献
4.
Long-Term Prognosis in Childhood Epilepsy: Survival and Seizure Prognosis   总被引:23,自引:23,他引:10  
L. O. Brorson  L. Wranne 《Epilepsia》1987,28(4):324-330
All children aged 0-19 years who had active epilepsy in a defined Swedish population were traced and given a clinical and psychometric investigation. Twelve years later, a follow-up study was carried out. Eleven of the 194 children had died, 8 of whom had had signs of neurodeficit, i.e., abnormal neurology and/or mental retardation. A long-standing remission of seizures occurred in 124 of the 194 children. Signs of neurodeficit, frequent seizures, and many types of seizures were negative prognostic factors. The presence of all these factors carried a bad prognosis, seizures persisting during 12 years in greater than 80%. For those who were mentally and neurologically normal and had low seizure frequency, prognosis was excellent, only 11% still having active epilepsy after 12 years. A study of the annual remission rate showed that each year approximately 13% of the children without neurodeficit had remission from epilepsy the next year. This rate appeared to be stable over the 12 years studied. Among those children with neurodeficit, the annual remission rate was high only during the first years after onset, later falling to 3% a year.  相似文献
5.
Some Aspects of Prognosis in the Epilepsies: A Review   总被引:20,自引:20,他引:15  
J. W. A. S. Sander 《Epilepsia》1993,34(6):1007-1016
6.
高血压脑出血不同术式治疗疗效的回顾性研究   总被引:20,自引:1,他引:19  
目的探讨高血压脑出血手术治疗方法及其适应证的选择和疗效。方法收集我院1998年1月-2003年7月采用定向引流、小骨窗开颅及骨瓣开颅三种术式治疗高血压脑出血158例,按照GCS评分和血肿量各分为3个亚组,并对各不同术式的手术适应症和疗效作一对比分析,最后得出结论。结果对高血压脑出血GCS评分较高(11~14分)、血肿量较小(20~50mL)的病人选用定向引流可降低致残率,中等量血肿(51~80mL)的病人采用小骨窗开颅能明显减少致残率,巨大血肿(〉80mL)的病人采用骨瓣开颅能明显降低死亡率。结论高血压脑出血手术治疗三种术式各有其优缺点,但小骨窗开颅具有手术创伤小,病人恢复快,并能及时有效地解除脑受压的特点,现不失为一种治疗高血压脑出血有效的治疗方法。  相似文献
7.
急性期高敏感C反应蛋白对脑梗死预后的评估   总被引:19,自引:0,他引:19  
目的探讨脑梗死急性期高敏感C反应蛋白(hs—CRP)对脑梗死远期预后的评估价值。方法选取首次急性脑梗死患者99例,在72h内检测血清hs—CRP,随访1年,将死亡及再发缺血性血管病变记录为终点事件。将所有患者分为CRP正常组(hs—CRP≤3mg/L)和CRP增高组(hs—CRP〉3mg/L),分别对两组患者进行生存分析比较。采用多变量Logistic回归分析hs—CRP增高、高血压、糖尿病、冠心病、高血脂、年龄、吸烟、饮酒等危险因素对终点事件的影响。结果hs—CRP〉3mg/L的患者较hs-CRP≤3mg/L的患者终点事件发生率显著增加(18.18%,5.45%;P=0.044;生存分析,log—rank检验)。多变量回归分析显示,hs—CRP增高(OR3.609;95%CI 0.869~14.992;P=0.047)和吸烟(OR4.094;95%CI1.092—15.340;P=0.037)与终点事件独立相关。结论脑梗死急性期hs—CRP增高可能是脑梗死发病1年内死亡和再发缺血性血管病变的独立危险因素。  相似文献
8.
An epidemiologic study of epilepsy in school age children has been carried out in Modena, Italy, during the period 1968 to 1973. The prevalence of epileptics aged 5 to 14 years varied between 3.98% and 4.91%. The accession rate varied between 60 and 98 cases /100,000. The primary generalized epilepsies represent 30.8%, the epilepsies with rolandic spike foci 23.9%, the other types of partial epilepsy 42.1%, and the Lennox-Gastaut syndrome 3.2%. Of the 178 epileptics diagnosed during school age, 159 have been followed for at least 4 years, with recovery in 55% of the cases and tendency to improve in 24%.  相似文献
9.
Mortality and neurological and mental outcome were studied in infants 28 days to 1 year of age with afebrile seizures not due to an acute postnatal injury. Cases were divided into four seizure types: infantile spasms: status epilepticus; and "others" (patients without spasms or status), generalized and partial. Mortality was studied in 334 cases, mental and neurological prognosis in 313 infants followed 1 year or more. Globally the prognosis was very poor even outside cases of infantile spasms. Mortality was higher and mental and neurological sequelae were more common in symptomatic than in cryptogenic cases. The highest mortality and greatest number of neurological defects were in status epilepticus and in "others" partial groups. Severely retarded subjects were more common in infantile spasms and "others" partial. The proportion of mentally normal patients, however, was no different according to ictal type. Mental and neurological prognosis was less unfavorable when the first seizure occurred at or over 6 months. A family history of epilepsy or febrile convulsions (21% of the cases in the whole series) was more common in the "others" subgroups, especially in the cryptogenic "others" (42%). The less unfavorable outcome obtained in cryptogenic "others" generalized with a positive family history.  相似文献
10.
Early Treatment and Prognosis of Epilepsy   总被引:14,自引:14,他引:10  
E. H. Reynolds 《Epilepsia》1987,28(2):97-106
Community-based studies and our own prospective hospital-based studies suggest that the prognosis for control of epilepsy is more favorable than previously reported. Approximately three quarters of newly diagnosed patients can enter prolonged remission on currently available medication. The first 2 years of treatment are crucial in determining the subsequent course of epilepsy. The longer seizures continue, the less likely they are to be controlled. Factors that contribute to the evolution of chronic epilepsy are the presence of brain lesions, neuropsychiatric handicaps, and poor compliance. Early effective treatment may also be important in preventing the evolution of chronic epilepsy. Recent studies have not revealed any significant differences in efficacy between the major antiepileptic drugs, and the choice of drug will therefore be influenced by costs and side effects, especially cognitive and behavioral effects. The majority of patients with a single unprovoked tonic-clonic seizure go on to develop epilepsy. Studies are required to evaluate the need for and outcome of therapy in such patients. Information about the natural history of untreated epilepsy, and also the possible influence of drug therapy on the prospects for spontaneous remission, is lacking.  相似文献
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