无菌性脑膜炎急性期继发癫痫的特点及危险因素

目的分析无菌性脑膜炎急性期继发癫痫发作的临床特点和危险因素。方法回顾性分析资料完整的急性无菌性脑炎患者138例，其中脑膜炎后癫痫患者21例，无癫痫发作者117例，系同期住院患者。病例和对照采用统一的调查表，用Microsoft Access2002建立数据库，共51个主项内容，部分主项有下属分项。总结癫痫发作的临床特点，对研究资料进行单因素分析和多因素非条件Logistic回归分析。结果全面发作14例（66．7％）。发病2周内出现抽搐者17例（81．0％）。经分析筛选出脑脊液蛋白含量升高、颅内压升高、脑电图低波幅3个因素为脑膜炎后继发癫痫的独立危险因素。结论无菌性脑膜炎后急性期癫痫以全面发作为主，多发生在发病2周内。脑脊液蛋白含量、颅内压升高和脑电图低波幅是癫痫发作的独立危险因素。

Clinical characteristics and risk factors for epilepsy during the acute phase of aseptic meningitis

Objective To analyze the clinical features and risk factors for epilepsy during the acute phase of aseptic meningitis. Methods 138 cases of aseptic meningitis with complete clinical data were retrospectively reviewed. Among them 21 had seizures, and 117 had not. All of them were inpatients in the same period after meningitis. Based on a standardized questionnaire, a database was established with Microsoft Access 2002 including 51 indexes and some subindexes. Univariate analysis and nonconditional multivariate stepwise logistic regression were carried out based on the summarization of the characters of clinical seizure. Results Fourteen cases (66.7%) manifested generalized seizures in those patients with epilepsy. Seventeen patients (80.1%) experienced epilepsy within 2 weeks after meningitis. The independent risk factors for seizures during the acute phase of aseptic meningitis were the increased contents of cerebrospinal fluid protein (OR=19.40), raised intracranial pressure (OR=8.848), and low-voltage activity in electroencephalogram (OR=5.039). Conclusions Generalized seizure is the major type of epilepsy induced by acute aseptic meningitis. Epilepsy occurred within 2 weeks in most patients with meningitis and seizures. High level of cerebrospinal fluid protein, raised intracranial pressure and low-voltage activity in electroencephalogram were the main predictive risk factors for epilepsy during the acute phase of aseptic meningitis.