Risk factors for fatality and neurological sequelae after status epilepticus in children
Risk factors for fatality and neurological sequelae after status epilepticus in children
复制标题
DOI：
10.1055/s-2005-865611
复制
发表时间：
2005-06-01
期刊：
影响因子：
1.4
通讯作者：
Ohno, K
中科院分区：
文献类型：
--
作者：
Maegaki, Y;Kurozawa, Y;Ohno, K
使用多变量回归分析，我们检查了儿童癫痫持续状态（SE）后死亡和神经系统后遗症的危险因素。可能的危险因素包括性别、发病年龄、SE病因、发热、SE期间哮喘发作、既往发作史、易感神经异常、发作持续时间、发作类型和茶碱药物。对1984年至2002年间转介到鸟取大学医院的1个月至18岁的连续SE患者进行了回顾。在纳入的234例患者中，45例（19.2%）患者预后不良，即9例早期死亡，36例神经系统后遗症。急性神经损伤和进行性神经疾病作为SE的病因与不良预后有非常显著的相关性（OR = 33.68, p = 0.000）。我们排除了21例病因为急性神经损伤和进行性神经疾病的患者，然后重新分析了其余213例患者的危险因素。29例（13.6%）预后不良，6例早期死亡，23例出现神经系统后遗症。发作时间超过2小时（OR = 12.73, p = 0.000）和中重度哮喘发作（OR = 31.61, p = 0.010）与预后不良相关。这些结果表明，持续的癫痫发作活动和哮喘发作可加重se相关的脑损伤。
Using multivariate regression analysis, we examined risk factors for fatality and neurological sequelae after status epilepticus (SE) in children. Possible risk factors included sex, age at onset, the cause of SE, pyrexia, asthmatic attack during SE, past history of seizure, predisposing neurological abnormality, seizure duration, type of seizure, and medication with theophylline. Consecutive patients with SE, aged 1 month to 18 years, who were referred to Tottori University Hospital from 1984 to 2002 were reviewed. Of the 234 patients enrolled, 45 patients (19.2%) showed poor outcomes, namely early death in 9 and neurological sequela in 36. Acute neurological insult and progressive neurological disease as the cause of SE were very significantly related to poor outcome (OR = 33.68, p = 0.000). We excluded 21 patients with the etiology of acute neurological insult and progressive neurological disease and then reanalyzed risk factors in the remaining 213 patients. Twenty-nine patients (13.6%) showed poor outcome, namely early death in 6 and neurological sequela in 23. Seizure duration of more than 2 hours (OR = 12.73, p = 0.000) and moderate to severe asthmatic attack (OR = 31.61, p = 0.010) were associated with poor outcome. These results indicate that long-lasting seizure activity and asthmatic attack can exacerbate SE-associated brain injury.