Seizure clustering:: Risks and outcomes
Seizure clustering:: Risks and outcomes
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DOI：
10.1111/j.0013-9580.2005.29004.x
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发表时间：
2005-01-01
期刊：
影响因子：
5.6
通讯作者：
Moshé, SL
中科院分区：
文献类型：
--
作者：
Haut, SR;Shinnar, S;Moshé, SL
目的：癫痫患者常出现丛集性癫痫发作。在这项初步研究中，我们检查了自我报告聚类的流行程度，并确定了与报告聚类相关的潜在风险因素和结果，以便在一项正在进行的前瞻性日记研究中进行进一步分析。方法：采用详细的摄入问卷。受试者报告他们的典型癫痫发作模式是在24小时内发作三次或更多次被归类为群集。获得磁共振成像（MRI）和脑电图数据，并按照国际抗癫痫联盟（ILAE）的标准对癫痫进行分类。所有受试者完成贝克焦虑抑郁量表和癫痫生活质量测试。结果：总体而言，29%的受试者报告了典型的癫痫发作聚类。颞外叶癫痫[p = 0.02；OR 3.0(1.1-7.8)]与报告的癫痫聚集性显著相关。远端症状性癫痫与聚类相关[p = 0.03；OR, 2.3(1.1-4.3)]，特别是与癫痫发作前头部创伤史和意识丧失相关[p = 0.003；OR, 4.2(1.6-11.1)]，尽管该分析是有限的。报告的聚类与惊厥癫痫持续状态（SE）史显著相关[p = 0.029；OR = 3.0(1.1-8.3)]，其他癫痫相关住院治疗[p = 0.006；OR为5.3(1.5-17.6)]，癫痫发作控制较差（p = 0.004）。生活质量测量与报告的聚类无显著关联。结论：这些初步结果确定了颞外癫痫和可能的头部创伤是报道的癫痫聚集性的潜在危险因素，并表明报道的聚集性与惊厥性SE之间存在显著关联。此外，发作聚集性似乎是难治性癫痫的标志。正在进行的日记研究将完善癫痫聚集性的定义，并进一步评估聚集性不良和良好结果的具体预测因素。
Purpose: Patients with epilepsy often experience seizures in clusters. In this preliminary study, we examined the prevalence of self-reported clustering and identified potential risk factors and outcomes associated with reported clustering for further analysis in an ongoing prospective diary study.Methods: Detailed intake questionnaires were administered. Subjects reporting their typical seizure pattern to be three or more seizures within a 24-h period were classified as clusterers. Magnetic resonance imaging (MRI) and EEG data were obtained, and epilepsy was classified by International League Against Epilepsy (ILAE) criteria. All subjects completed Beck Anxiety and Depression Inventories, and Quality of Life in Epilepsy testing.Results: Overall, 29 % of subjects reported typical seizure clustering. Extratemporal lobe epilepsy [p = 0.02; OR, 3.0 (1.1-7.8)] was significantly associated with reported seizure clustering. Remote symptomatic epilepsy was associated with clustering [p = 0.03; OR, 2.3 (1.1-4.3)], particularly in association with a history of head trauma with loss of consciousness before epilepsy onset [p = 0.003; OR, 4.2 (1.6-11.1)], although this analysis was limited. Reported clustering was significantly associated with a history of convulsive status epilepticus (SE) [p = 0.029; OR, 3.0 (1.1-8.3)], other seizure-related hospitalization [p = 0.006; OR, 5.3 (1.5-17.6)], and worse seizure control (p = 0.004). Quality-of-life measures were not significantly associated with reported clustering.Conclusions: These preliminary results identify extratemporal epilepsy and possibly head trauma as potential risk factors for reported seizure clustering and indicate a significant association between reported clustering and convulsive SE. Additionally, seizure clustering appears to be a marker for more intractable epilepsy. The ongoing diary study will refine the definition of seizure clustering and further evaluate specific predictors of poor and favorable outcomes of clustering.