病毒性脑炎急性期继发癫痫的临床特点

目的:分析病毒性脑炎急性期继发癫痫的临床特点。方法:1982年4月5日～2003年12月15日连续住院的374例病毒性脑炎患者,采用统一的调查表,用Microsoft Access 2002建立数据库,共51个主项内容,部分主项有下属分项。分析患者癫痫发病情况,对比观察继发癫痫患者和无癫痫发作患者脑电图结果及预后情况。结果:374例中115例(30.8％)继发癫痫,其中全面发作72例(62.6％),单纯部分发作18例,复杂部分发作11例,部分继发全面14例。115例患者中23例(20.0％)出现癫痫持续状态,14例(12.2％)继发多系统损害,普通脑电图检查20例发现痫性放电,占17.4％。继发癫痫组额叶、颞叶损害共54例,占47.0％。继发癫痫组与无癫痫发作组比较,脑电图异常程度差异有显著意义(x2=23.6,P<0.01),大脑皮质损害发生率差异有显著意义(x2=85.53,P<0.001)。继发癫痫组住院天数26.1±23.6,无癫痫发作组住院天数17.9±5.0,二者比较差异有显著意义(t=5.33,P<0.001)。结论:急性病毒性脑炎后继发癫痫发作以全面发作最为常见,大脑皮质损害易于继发癫痫,癫痫发作影响病毒性脑炎患者病情恢复。

Clinical characteristics of epilepsy during the acute phase of viral encephalitis

Objective: The purpose of this study was to analyze the characteristics of epilepsy during the acute phase of viral encephalitis. Methods: From April 1982 to December 2003, we retrospectively studied 374 patients with viral encephalitis admitted to the Division of Neurology at our hospital during the acute phase. of these patients. 115 had epilepsy, 259 patients had not epilepsy. All of them were inpatients in the same period after encephalitis. Based on a standardized questionnaire, a batabase was made with Microsoft Access 2002, the data included 51 indexes and some subindexes. The features of epilepsy were summarized. The Comparison of electroencephalography and prognosis between patients with and without epilepsy was made. Results: of the 374 cases, 115(30. 8%) patients suffered from epilepsy. of those epilepsy patients, 72 cases(62. 6%) had generalized seizure, 18 cases had simple partial seizure,11 cases had complex partial seizure, 14 cases had partial seizure evolving to secondarily generalized seizure. Twenty-three patients(20. 0%) had status epilepticus. Fourteen patients(12. 2%) had multisystemic damages. Routine electroencephalography examination showed epileptic discharges in 20 patients(17. 4%). damages in frontal lobe or temporal lobe occurred in 54(47. 0%) patients with epilepsy. There was significant difference about the degree of abnormal electroencephalography(x2 =23. 6, P<0. 01) and cortical involvements(x2 =85. 53, P<0. 001) between the groups with epilepsy and without epilepsy. The duration of hospitalization was significant longer (t=5. 33, P<0. 001) in groups with epilepsy(26. 1±23. 6 days) than in groups without epilepsy(17. 9±5. 0 days). Conclusions: Generalized epilepsy is the main type of epilepsy after acute viral encephalitis. The patients with cortical involvements tend to develop epilepsy. Onset of epilepsy affects the prognosis of the patients with acute viral encephalitis.