Risk factors for posttraumatic seizures in adults
Risk factors for posttraumatic seizures in adults
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DOI：
10.1046/j.1528-1157.44.s10.6.x
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发表时间：
2003-01-01
期刊：
影响因子：
5.6
通讯作者：
Temkin, NR
中科院分区：
文献类型：
--
作者：
Temkin, NR
目的：人们早就知道外伤性脑损伤是癫痫的一个原因。大多数关于发生创伤后癫痫发作的危险因素的信息都是在计算机断层扫描 (CT) 扫描普及之前提供的。本文着眼于使人们处于发生创伤后癫痫发作特别高风险的伤害或个人因素。方法：我们考虑了 783 名发生癫痫发作高风险的病例，并随访了 2 年，作为癫痫发作预防研究的一部分。亚组中癫痫发作的累积发生率和标准化发生率用于确定与无端癫痫发作风险相关的因素。结果：风险显着升高的亚组包括硬膜下血肿清除的亚组；脑内血肿手术；格拉斯哥昏迷评分严重程度为 3 至 8；早期癫痫发作，尤其是延迟性早期癫痫发作；执行一周或更长时间命令的时间；未通过手术抬高的凹陷性颅骨骨折；受伤造成的硬脑膜穿透；至少一名无反应的瞳孔；结论：风险因素和风险的时间进程对于设计癫痫预防研究都很重要，如果确定了有效的预防方案，对于决定适当的预防方案也很重要。
Purpose: Traumatic brain injury has long been known to be a cause of epilepsy. Most information on risk factors for developing posttraumatic seizures is from before computed tomography (CT) scanning became universal. This article looks at factors about the injury or individual that put people at especially high risk of developing posttraumatic seizures.Methods: We considered 783 cases at high risk of developing seizures, followed up for 2 years as part of seizure prophylaxis studies. Cumulative incidence of seizures in subgroups and standardized incidence ratios were used to identify factors related to unprovoked seizure risk.Results: Subgroups with significantly elevated risk include those with evacuation of a subdural hematoma; surgery for an intracerebral hematoma; Glasgow Coma Scale in the severe range of 3 to 8; early seizures, especially delayed early seizures; time to following commands of a week or more; depressed skull fracture that was not surgically elevated; dural penetration by injury; at least one nonreactive pupil; and parietal lesions on CT scan.Conclusions: Both the risk factors and the time course of the risk are important for designing seizure-prophylaxis studies and, if an effective prophylactic regimen is identified, for deciding on appropriate candidates for prophylaxis.