病毒性脑炎后癫痫的预后及其影响因素

目的探讨病毒性脑炎后癫痫(PEE)的预后及其影响因素。方法对50例病毒性脑炎伴PEE患者进行随访,以从未达到1年无发作为预后差评价指标,观察其预后。收集患者的临床资料,分析影响PEE预后差的危险因素。结果预后差组患者脑炎急性期有意识障碍及脑炎急性期有痫性发作、发作次数10次的比率显著高于预后好组(均P0.01)。年龄、性别、发作类型、脑炎急性期精神障碍、脑炎急性期神经系统缺损、脑炎急性期SE、CSF细胞数增多、EEG异常、头颅CT/MRI异常与预后差无相关性(均P0.05)。多因素Logistic回归分析显示,脑炎急性期意识障碍、脑炎急性期发作是PEE患者预后差的独立危险因素(OR=7.269,95%CI:1.22~43.35,P=0.029;OR=22.893,95%CI:4.02~130.43,P=0.000)。结论脑炎急性期意识障碍、脑炎急性期痫性发作是影响PEE预后差的独立危险因素。

Prognosis and its influencing factors of post-encephalitic epilepsy

Objective To investigate the prognosis and its influencing factors of post-encephalitic epilepsy ( PEE) .Methods Fifty viral encephalitis patients with PEE were followed up, which prognosis was observed by whether their no seizures for at least 1 year or not.The clinical data of patients was collected, and the relate risk factors on the poor prognosis of PEE were analyzed.Results The disturbance of consciousness and the seizure presence during acute encephalitis, more than ten seizures in poor prognosis group were much higner than the good one (all P<0.01).The age, sex, seizure type, dysphrenia and neurological defect in acute encephalitis, status epileptisus in acute encephalitis, abnormal EEG and abnormal head CT/MRI had no correlation with poor prognosis ( all P>0.05 ) .Multiple logistic regression analysis demonstrated that disturbance of consciousness during acute encephalitis、seizures presence in acute encephalitis were independent risk factors of poor outcome in PEE ( OR=7.269,95%CI:1.22 -43.35,P=0.029;OR =22.893,95%CI:4.02 -130.43,P=0.000).Conclusion Disturbance of consciousness during acute encephalitis, seizure presence in acute encephalitis both are the single risk factors of poor prognosis in PEE.