热性惊厥史与青少年癫痫病因关系临床分析

目的 分析有热性惊厥史的青少年癫痫患者临床特点和治疗情况,探讨热性惊厥史与青少年癫痫之间的关系。方法 对发病年龄〈18岁的青少年癫痫患者的病因进行回顾分析,总结单纯性和复杂性热性惊厥患者癫痫发作特点、辅助检查和服药情况。结果 符合癫痫诊断标准的4595例患者中发病年龄〈18岁者2699例占58.74%,其中原发性癫痫1573例占58.28%、继发性癫痫1126例占41.72%。青少年继发性癫痫以热性惊厥（297例占26.38%）为主要病因,其中单纯性热性惊厥200例、复杂性热性惊厥97例,均以部分性发作为主（χ^2=4.933,P=0.026）。有热性惊厥史患者神经影像学（χ^2=38.083,P=0.000）和神经电生理学（χ^2=4.469,P=0.035）异常检出率明显增加;其中服药率约为66.67%（198/297）,服用传统抗癫痫药物者占70.20%（139/198）。结论 青少年继发性癫痫病因较为复杂,以热性惊厥为主要病因。无论单纯性或复杂性热性惊厥均以部分性发作常见,仍以传统抗癫痫药物为主,约1/3患者未服药或未正规服药。

Clinical analysis on the relationship between febrile seizure and epileptic etiology in adolescents

Objective To analyze the clinical characteristics and treatment of young epileptic patients with febrile seizure （FS） history, and to investigate the relationship between febrile seizure and epileptic attack in adolescents. Methods The clinical data of epileptic patients with the onset age 〈 18 from Chinese PLA General Hospital during October 2002 to July 2010 and their epileptic etiology were collected and retrospectively analyzed. The clinical characteristics, accessory examination results and treatment of these patients with ＇simple febrile seizure （SFS） and complex febrile seizure （CFS） were analyzed. Results According to diagnostic criteria of epilepsy, 2699 cases （58.74%） with the onset age 〈 18 were collected from 4595 cases, including 1573 cases （58.28%） with idiopathic epilepsy and 1126 cases （41.72%） with secondary epilepsy. Febrile seizure （297 cases, 26.38%） was the main cause of adolescent secondary epilepsy, including simple febrile seizure in 200 cases and complex febrile seizure in 97 cases. Partial seizure was the main attack type （x^2 = 4.933, P = 0.026）. The abnormal rate of neuroimaging （x^2 = 38.083, P = 0.000） and neuroelectrophysiological （x^2= 4.469, P = 0.035） in patients with febrile seizure history were obviously increased. The rate of antiepileptic drugs （AEDs） therapy was 66.67% （198/297）, and patients who had taken traditional antiepileptie drugs accounted for 70.20% （139/198）. Conclusions The causes of secondary epilepsy in adolescents were various, with febrile seizure as the major one. Partial seizure was the main attack type in both simple febrile seizure and complex febrile seizure. Traditional antiepileptic drugs therapy was chosen more. However, nearly one-third patients took no medicine or took their medicine irregularly.