慢性酒精中毒伴发癫痫发作临床分析

目的··:探讨慢性酒精中毒伴发癫痫发作的临床特点及转归。方法··:对1988年1月 -1999年12月间住院病人中 ,17例慢性酒精中毒伴发癫痫患者的饮酒情况、临床表现和脑电图等实验室检查资料进行回顾性分析。结果·· :17例患者的平均饮酒史22.3a±s7.51a;平均饮酒量345.52g·d-1±s109.63g·d-1;酒精中毒的精神症状以幻觉 (7例 )和妄想症 (4例 )为主 ;癫痫发作多出现在戒酒后48 -96h之间 (7例 ,占41.8 % )和饮酒量加大时 (5例 ,占29.4 % ) ,饮酒量无变化时的比例也很高 (4例 ,占23.5 % ) ;癫痫发作表现为全身强直 -痉挛发作 (16例,94.1 % ) ;脑电图异常者8例(8/14) ,脑萎缩6例 ;经治疗 ,13例 (76.5 % )痊愈;3(17.7%)明显好转 ;1例 (5.9 % )好转。结论·· :慢性酒精中毒可伴发癫痫,其发生与饮酒史、饮酒量、突然停酒及酒精对大脑的损伤有关 ;癫痫症状严重 ,近期治疗效果好。

CHRONIC ALCOHOLISM COMPLICATED BY EPILEPTIC ATTACKS

Objective: To study the clinical features and consequences of chronic alcoholism complicated by epilepsy .Methods:The clinical features,drinking pattern,laboratory tests, electroencephalogram (EEG) of 17 male who were diagnosed as chronic alcoholism complicated by epileptic attacks from Jan. 1988 to Dec. 1999 were collected and analyzed. Results: The mean score of drinking history and the average dosage of the 17 patients were 22.3 a±s 57.5 a and 345.5 g·d-1±s 109.6 g·d-1, respectively. Among them, 7 patients (41.8%) had epileptic attacks when discontinued drinking within 48-96 h; 6(35.3%) had it when increased or decreased dosage suddenly; 4 had it unrelated with dosage change. 16 patients (94.1%) encountered tonic seizure; 8 patients (8/14) had abnormal EEG, of whom 6 had cerebral atrophy. After treatment 13 patients (76.5%) recovered; 3(17.7%) got significantly better; 1(5.9%) better. Conclusion:Chronic alcoholism complicated by epileptic attacks is mainly associated with drinking history ,sudden withdrawal and dosage change. Pathogenesis includes brain injury secondary to alcohol. Short time treatment produces good effect.