儿童外伤性癫痫的危险因素评价

目的对儿童外伤性癫痫发病的危险因素进行评价,为临床干预提供依据.方法对138例外伤性脑损伤患儿的临床资料进行回顾性分析,其中开放性颅脑损伤86例,闭合性颅脑损伤52例;轻度颅脑损伤67例,中重度颅脑损伤71例;皮层受损95例,皮层外其他部位受损43例;外伤性癫痫29例.结果对闭合性颅脑损伤与开放性颅脑损伤、轻度颅脑损伤与中重度颅脑损伤、皮层受损与其他部位受损引起的外伤性癫痫的发病例数分别进行x2检验,P均＜0.05.结论开放性颅脑损伤、颅脑损伤程度重、皮层受损者外伤性癫痫发病率明显增高.对颅脑损伤患者,应结合临床特点、脑电图、神经影像学资料综合评价其危险因素,从而早期进行临床干预.

Evalution of the risk factors of posttraumatic epilepsy

Objective Posttraumatic epilepsy(PTE) is a serious complication after traumatic brain injury. However, the early diagnosis of posttraumatic seizure is very difficult. We try to assess the risk factors of PTE for early rational treatment of AED. Methods 138 cases with craniocerebral injury were retrospectively analysized. The cases were between Oct. 1998 and Oct. 2004. 86 cases had open craniocerebral injury. 52 cases had closed craniocerebral injury. 67 cases had mild, and 71 cases had moderate or sever craniocerebral injury. 95 cases had cortical or subcortical injury and 43 cases had other parts injuries. 29 cases had posttraumatic epilepsy. Results The three groups had statistically significant difference in the occurrence of posttraumatic epilepsy. Conclusions Open craniocerebral injury, severe craniocerebral injury and cortical injury are the risk factors that have prognostic value for PTE. We think that it is very important to assess PTE by combining the clinical feature, neuroradiologic and neuropsychological findings after brain trauma. Early intervention should be initiated in the patients with three risk factors.