Recurrence of afebrile status epilepticus in a population-based study in Rochester, Minnesota
Recurrence of afebrile status epilepticus in a population-based study in Rochester, Minnesota
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DOI：
10.1212/01.wnl.0000265056.31752.ff
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发表时间：
2007-07-03
期刊：
影响因子：
9.9
通讯作者：
Hauser, W. A.
中科院分区：
文献类型：
--
作者：
Hesdorffer, D. C.;Logroscino, G.;Hauser, W. A.
为了确定复发的癫痫持续状态（SE）的风险，以人口为基础的sample，并确定复发的危险因素。方法：我们确定所有的第一次发作的无发热SE的居民罗切斯特，MN，通过罗切斯特流行病学项目的recordslinkage系统之间的1965年1月1日，1984年12月31日。信息收集年龄，性别，持续时间，癫痫发作类型，病因，治疗反应，最初的抗癫痫药物治疗，随后发作的SE.Results：在183次发作的第一次无热SE，复发SE的风险是31.7%，超过10年的随访期。急性症状性SE、远程症状性SE和特发性隐源性SE患者的复发风险约为25%。进行性症状性SE患者的复发率为100%。女性（率比[RR] = 2.3，95% CI =1.1 - 5.0）和进行性症状性病因（RR = 2.4，95% CI = 0.6 - 8.9）增加了复发性SE的风险。部分SE（RR = 0.5，95%CI = 0.2至1.1）和良好的治疗反应，以最初的抗癫痫药物治疗（RR = 0.3，95%CI = 0.1至0.7）与复发SE.Conclusions的风险降低：癫痫持续状态（SE）复发约三分之一的个人与SE的第一次发作。除了SE发生在进行性脑部疾病的情况下，无论潜在病因如何，复发的风险约为25%。女性性别和SE首次发作后对第一种抗癫痫药物缺乏反应表明这些人复发风险最大。
To determine the risk of recurrence of status epilepticus (SE) in a population-based sample and to identify risk factors for recurrence.Methods: We ascertained all first episodes of afebrile SE in residents of Rochester, MN, through the Rochester Epidemiology Project's recordslinkage system between January 1, 1965, and December 31, 1984. Information was collected on age, gender, duration, seizure type, etiology, therapeutic response to initial antiepileptic drug medication, and subsequent episodes of SE.Results: Among the 183 episodes of first afebrile SE, the risk of recurrent SE was 31.7% over a 10- year follow- up period. The risk of recurrence was about 25% for those with acute symptomatic SE, remote symptomatic SE, and idiopathic cryptogenic SE. Recurrence was 100% for those with progressive symptomatic SE. Female gender (rate ratio [RR] = 2.3, 95% Cl =1.1 to 5.0) and progressive symptomatic etiology (RR = 2.4, 95% Cl = 0.6 to 8.9) increased the risk for recurrent SE. Both partial SE (RR = 0.5, 95% Cl = 0.2 to 1.1) and good therapeutic response to the initial antiepileptic drug therapy (RR = 0.3, 95% Cl = 0.1 to 0.7) were associated with a decreased risk of recurrent SE.Conclusions: Status epilepticus ( SE) recurs in about one-third of individuals with a first episode of SE. Except for SE occurring in the setting a progressive brain disorder, the risk of recurrence is about 25%, regardless of the underlying etiology. Female gender and lack of response to the first antiepileptic drug medication after the initial episode of SE identify those individuals at greatest risk for recurrence.