Nonepileptic posttraumatic seizures
Nonepileptic posttraumatic seizures
复制标题
DOI：
10.1111/j.1528-1157.1998.tb01395.x
复制
发表时间：
1998-04-01
期刊：
影响因子：
5.6
通讯作者：
Grattan, L
中科院分区：
文献类型：
--
作者：
Barry, E;Krumholz, A;Grattan, L
目的：癫痫性创伤后癫痫发作（PTS）是脑损伤（HI）的一个公认的后果，但HI和非癫痫性癫痫发作（NES）没有相关性。我们描述了NES患者的一个重要子集，这些患者的癫痫发作归因于HI。方法：我们回顾了马里兰州大学医学中心B年期间诊断为内斯的所有患者的记录（1989-1995）和选定的癫痫发作归因于头部损伤的患者发生不到或等于3年前他们的癫痫发作。在157例经视频脑电图证实为内斯的患者中，37例（24%）的癫痫发作归因于HI。他们的平均年龄为34岁（范围为15-56岁）; 68%为女性。非癫痫性PTS通常在HI后第一年内发生（89%）。54%出现惊厥症状。而癫痫性PTSs的特点是严重的HI，大多数（78%）的非癫痫性PTSs患者持续轻度HI。在他们的HI，76%的病人受雇，在家里工作，或学生，但只有11%可以继续这些活动后，发展nonepileptic PTSs.Conclusions：Nonepileptic PTSs经常被误认为癫痫PTSs，并导致严重残疾。非癫痫性PTSS的误诊导致无效和不适当的治疗。对于HI后顽固性癫痫发作的患者，尤其是轻度HI，应仔细评估NES。
Purpose: Epileptic posttraumatic seizures (PTSs) are a well-recognized consequence of head injury (HI), but HI and nonepileptic seizures (NESs) have not been related. We describe a significant subset of patients with NESs who had their seizures attributed to HI.Methods: We reviewed the records of all patients diagnosed with NES at the University of Maryland Medical Center over a B-year period (1989-1995) and selected patients with seizures attributed to a head injury occurring less than or equal to 3 years before the onset of their seizures.Results: Of 157 patients with video-EEG confirmed NES, 37 (24%) had the onset of their seizures attributed to an HI. Their average age was 34 years (range, 15-56 years); 68% were women. Nonepileptic PTS usually developed within the first year after HI (89%). Convulsive symptoms were present in 54%. Whereas epileptic PTSs characteristically follow severe HI, the majority (78%) of our patients with nonepileptic PTSs sustained only mild HI. Before their HI, 76% of our patients were employed, working in the home, or students, but only 11% could continue those activities after developing nonepileptic PTSs.Conclusions: Nonepileptic PTSs are frequently mistaken for epileptic PTSs and result in serious disability. The misdiagnosis of nonepileptic PTSs leads to ineffective and inappropriate treatment. Patients with intractable seizures after HIs, particularly mild HIs, should be carefully evaluated for NESs.